Acute abdominal pain related to the female genital organs is frequently encountered in the emergency department. Gynecological emergencies are diseases of the female reproductive system that are potentially life-threatening and peril the sexual function and fertility. In the diagnostic work-up of acute abdominal pain, a wide variety of differential diagnoses needs to be considered depending on the age of the patient and a concomitant pregnancy. There is significant clinical overlap with gastrointestinal emergencies. Therefore, imaging plays a key role in diagnosing the cause of the pain and the planning of the therapy. The aim of this review is to illustrate the significant role of imaging in frequently encountered gynaecologic emergencies.