Objective:To compare the effect of traditional laparotomy and laparoscopy to surgical treatment of acute abdomen.Methods: Retrospective analyses of 232 cases of acute abdomen were treated with laparotomy and laparoscopic surgery and complications trial situation.Results: The patients of appendicitis,gallstones were underwent laparoscopic surgery mainly,and most of the perforation and the organ injury were received aparotomy.Conclusions: The effect of Laparoscopy in the therapy of appendicitis,gallstones,perforation and limited acute abdomen are better than laparotomy,but with severe complications and broader acute abdomen,early laparotomy is still appropriate.