Acute abdomen is one of the most common emergencies in clinical emergency departments, characterized mainly by acute abdominal pain. It involves multiple disciplines including internal medicine, surgery, obstetrics and gynecology, and pediatrics, with complex etiologies and rapid progression. Misdiagnosis or delayed treatment can easily worsen the condition and even endanger the patient’s life. With the development of medical technologies and diagnosis-treatment models such as artificial intelligence and precision medicine, the system for differential diagnosis and treatment of medical acute abdomen has been continuously improved, providing new ideas and methods for clinicians. Based on clinical practice, this paper summarizes the key points of differential diagnosis and standardized treatment of medical acute abdomen, and discusses the development trend of its clinical diagnosis and treatment, so as to provide a reference for clinical practice.