Acute abdominal pain is one of the most frequent complaints of patients presenting to the Emergency Department. It continues to pose diagnostic challenges for emergency clinicians and primary care doctors Common causes include Adnexal torsion, ruptured ectopic pregnancy, Fibroids, Pelvic inflammatory disease, acute appendicitis and Mittelschmerz. Our study aims at studying the profile of acute abdominal pain in adult females [132 patients] presenting to the ED of a tertiary hospital in south India. Lower abdominal pain was reported by 45.8% of participants, while pain was generalized in 27.3% of patients. The majority of patients (64.8%) did not have any radiation of the pain. The final diagnosis at discharge was grouped as Pelvic inflammatory disease (10.6%), acute appendicitis (7.2%), Ruptured ectopic (5.3%), Adnexal torsion (4.2%) and fibroid uterus (3.8%) which were most common etiologies