Introduction & Objective: Emergent laparotomy has many usages in abdomen trauma and acute abdomen. Knowing its common causes and patient's conditions will be useful for good management of these patients. This study determined the common etiologies of emergent laparotomy and evaluated these causes.

Materials & Methods: This descriptive and retrospective study was carried out on patients who had received laparotomy and their dossiers were available in archives of Beheshty and Yahya Nejad hospitals.

Results: 300 patients were laparotomised (201 male and 99 female). 69 out of these patients had received laparotomy because of trauma (48 blunt and 21 penetrating) and 231 of them for acute abdomen. The most common signs were tenderness and guarding. Most of the patients were in 11-20 and 21-30 years age groups. In trauma: most common causes of injury were car accident and stab wounds. It usually happens in the third decade of the life. Accuracy of physical examinations was 91% by using three criteria of hypotension, tenderness and guarding. Negative laparotomy was 4 in blunt and 10 in penetrating trauma. Most common injured organs were spleen in blunt and intestine in penetrating traumas. In acute abdomen: most common causes for emergent laparotomy were peritonitis (43%) and obstruction (25%). Negative laparotomy was 3 in acute abdomen. P.U (4.46%) and perforated appendicitis (4.36%) were the most common causes of peritonitis. Rate of mortality in 5 cases was for   trauma patients and 4 in cases for acute abdomen patients.

Conclusion: This study proved that acute abdomen was the most common cause of emergent laparotomy and peritonitis and intestine obstruction were the common causes of acute abdomen which lead in laparotomy. In traumatic patients, blunt trauma (resulting from car accident) was the most regardable factor of emergent laparotomy (resulting from car accident)