Background: Acute abdomen is ranking as the third common chief complaint of patients presenting to emergency departments. Objective of the study was to evaluate the emergency nurses’ practice regarding patients with acute abdominal. Design: A descriptive research design was used in this study. Setting: The study was carried out in emergency departments at Assuit University Hospital and central Abou-Teeg Hospital. Subject: A total sample of (36) emergency nurses who provide direct patient care were included in this work. Tools: Two tools were utilized to collect data. Tool I developed by the researcher to identify emergency nurses’ characteristics. Tool II acute abdomen observational checklist included 64 steps regarding the six items of acute abdomen practice; preparation (6 steps), history (16 steps), assessment (1 steps), physical examination (26 steps), collaborative management (12 steps), and documentation (3 steps). Methods: Data collection took approximately 6 months starting from February till July 2016. Each nurse was observed once in per shift using tool 2. Results: The finding revealed that most of taking history steps done correctly by 100% of emergency nurses at both hospitals. An assessment steps were done incorrectly by 50% of emergency nurses at Assuit University and Abou-Teeg hospitals respectively. Conclusion: It was concluded that most items of acute abdomen practice regarding preparation, assessment, physical examination, collaborative management, and documentation were done correctly by low percentages especially among emergency nurses at Abouteeg hospitals.