Abdominal pain is a frequent symptom among elderly hospitalized patients. Taking the patient's history is often difficult because of a cognitive impairment. The objective of the present article is to provide a short summery of important diseases leading to abdominal pain and their special features in the elderly patient population. Especially atypical and less symptomatic courses render establishing the correct diagnosis more difficult. The higher comorbidity, the often more advanced disease stage at the time of seeking medical attention and an delayed accurate diagnosis all contribute to the higher mortality in the elderly patients.