Acute pelvic pain in women is a frequent cause of emergency hospital admission. Because the source may be either gynaecological or non-gynaecologic and because of the complex anatomy of the pelvic area, the differential diagnosis of the underlying disease is extensive. In such cases ultrasonography is the procedure of choice, as it leads to a diagnosis in most cases. Sometimes, however, when the sonographic findings are non-diagnostic or disagree with the clinical picture, especially in acutely ill patients, a Computed Tomography (CT) scan of the abdomen and pelvis can assist in the diagnosis. We present the CT features of different gynaecological and non-gynaecological conditions in women presenting to the Emergency Room with acute pelvic pain.