Aim of the study: The purpose of this article is to report the experience of the General Reference Hospital in the surgical management of abdominal emergencies. Patients and Methods: This was a prospective study over 3 years 5 months (08/12/2017 to 31/05/2021) which concerned patients operated for an abdominal emergency at the General Reference Hospital of Niamey. Results: We had 170 patients operated for an abdominal emergency (8.37%), with a male predominance (61.50%) and a sex ratio of 1.59. The average age was 36.08 years with a standard deviation of 17.46 and extremes of 2 to 79 years. Non-traumatic abdominal emergencies dominated with 96.47%. Abdominal ultrasound was performed in 92.35% (n=157) of patients and abdominal CT scan in 35.88% (n=61). General anesthesia was performed in 97.06% of cases (n=165). The approaches were laparotomy in 72.35% (n=123) and laparoscopy in 27.65% (n=47). The most reported intraoperative diagnoses were acute appendicitis 40.59% (n=69) followed by acute peritonitis 18.82% (n= 32) and acute cholecystitis 13,53% (n= 23). The main procedures performed by laparoscopy were appendectomies, cholecystectomies and acute peritonitis in respectively 15.29%, 10.59% and 1.76% of cases. Postoperative complications represented 2.35% (n=4) in laparoscopy and 9.41% (n=16) in laparotomy. Conclusion: Abdominal emergencies at the Reference General Hospital are frequent and postoperative complications are few especially at laparoscopy, which is a first way to encourage in our context; It gives better surgical outcomes than conventional surgery.