Background: The term "acute abdomen" describes the abrupt onset of excruciating abdominal discomfort that need immediate medical attention and frequently surgery. It can be brought on by a number of underlying illnesses and is a symptom rather than a diagnosis. The present study was conducted to assess acute abdominal condition in pregnancy. Materials & Methods: 90 pregnant women in different trimester who reported with acute abdominal pain were enrolled. The causes of acute abdominal conditions, both obstetric and non-obstetric, were noted. Results: In age group 10-20 years, 20-30 years, 30-40 years and 40-50 years, ectopic pregnancy was seen in 3, 1, 0 and 1. Abruptio placenta was seen in 23, 9, 8 and 7. Acute appendicitis was seen in 7, 7, 2 and 1. Acute cholecystitis was seen in 2, 4, 2 and 2, Hellp syndrome in 3, 1, 1 and 0, twisted ovarian cyst in 2, 3, 0 and 1 patient respectively. Maximum cases were seen in 1st trimester (49) followed by 3rd (21) and 2nd (19). Maximum cases of Abruptio placenta (14) were seen in 1st trimester, acute appendicitis in 1st, acute cholecystitis in 1st, Hellp Syndrome in 2nd and 3rd, twisted ovarian cyst in 1st and 2nd trimester. The difference was non- significant (P> 0.05). Conclusion: One of the primary causes of acute abdomen during pregnancy is abruptio placenta, which is followed by acute appendicitis.