Introduction and research objectives: Acute abdomen is a serious condition that requires urgent diagnosis and treatment due to its diverse etiology and high risk of complications. The aim of this study is to investigate the frequency of surgery for acute abdomen in Zadar General Hospital between 2020 and 2023, with special attention to the distribution across age groups, gender differences, main indications for surgery and comparison between classical and laparoscopic surgery. Materials and methods: The study was conducted on patients over the age of 18 who underwent acute abdominal surgery at Zadar General Hospital between January 2020 and December 2023. Data were collected retrospectively from medical records, analyzed using SPSS software and processed using absolute and relative frequencies and the chi-square test to assess statistical significance. Ethical compliance was ensured by ethics committee approval, and data were anonymized and stored in accordance with legal and ethical guidelines. Results: In the study conducted on 1881 patients, the majority were men (56.2 %) and 43.8 % women. The most common diagnosis was appendicitis (29.4 %), and the average length of hospital stay was 7 days. Operations were most frequently performed in August, and 30.4% of all operations were laparoscopic procedures. Statistically significant differences were found between genders and age groups in the frequency of laparoscopic surgery and the main diagnosis. The older age group had a lower percentage of operations, while the highest operation rate was recorded in the 18-29 age group. Conclusion: The study showed that the frequency of operations with acute abdomen was highest in the 50-69 age group, so hypothesis H1 could not be confirmed. Appendicitis was the most common indication for surgery, confirming hypothesis H3, while the number of classic operations was significantly higher than laparoscopic operations, confirming hypothesis H4. The results underline the importance of tailored medical approaches and continuous training of medical staff to improve surgical outcomes.