We performed a structured retrospective chart review to describe clinical characteristics of Emergency Department (ED) patients diagnosed by history, physical examination, and abdominal computed tomography (CT) scan with epiploic appendagitis (EA). EA is a disease caused by inflammation of the appendix epiploica, subserosal adipose tissue along the colon. It may mimic surgical causes of acute abdominal pain, but is treated conservatively with pain management. There were 19 patients diagnosed with EA, with follow-up performed on 85%. All had focal, nonmigratory symptoms. Common findings included left lower quadrant pain and guarding, and a normal temperature and white cell count. No patient required operation. This preliminary work characterizes some common clinical features of ED patients diagnosed with EA. As use of emergency CT scan for abdominal pain increases, clinicians will encounter this more often. These features should also prompt the clinician to consider CT scan in patients with similar signs and symptoms. Accurate diagnosis may avoid unnecessary surgery.