This is a prospective study conducted in all major hospitals in Basrah (Basrah Maternity & Child ‎Hospital, Basrah Teaching hospital and Basra General hospital) to prove that ‘acute abdomen in ‎pregnancy’ is common and that the effect of delayed diagnosis can have serious implication on both ‎maternal and fetal outcome. Two hundred and fourteen pregnant females were included. Their age ranged ‎from 16-42 years (mean age was 27 years). Operations were performed whenever indicated by a registrar ‎or consultant gynecologist. Abruption placenta was the causative factor in 33.17% of cases, ectopic ‎gestation in 24.7%, acute appendicitis in 11.21% and the remaining 30.9% resulted from miscellaneous ‎conditions. Most of the patients (94.39%) presented within the first twenty-four hours of their initial ‎complaint. Delayed diagnoses were made in 12 with 50% maternal mortality and 100% perinatal mortality. ‎One hundred and sixty nine patients (78.97%) underwent emergency operations, while forty-five patients ‎‎(21.02%) were treated conservatively. Various complications were encountered; the most common was ‎wound infection (19.8%).‎