The study was carried out to determine the pattern of Paediatric Surgical Abdominal Emergencies (PSAE) at the University of Ilorin Teaching Hospital. It was a prospective study of all children aged 12years and below presenting to the paediatric surgical unit, Department of surgery, between 1st of October 2002, and 31st December, 2003. Paediatric Surgical Abdominal Emergencies (PSAE) occurred in 3.4% of all paediatric admissions during this period. Male to female ratio was 2.5: 1. Forty (40%) of PSAE occurred most commonly during late childhood (7yr – 12yrs), followed by 21% in neonatal period (< 1mth) and 20% in infancy (1month to 12month). Mechanical intestinal obstruction was the most common cause of PSAE accounting for 44% of cases, followed by peritonitis caused by typhoid perforation in 22% of cases. Other causes were acute appendicitis in 15%, abdominal trauma, 7%, infantile hypertrophic pyloric stenosis, 3% and miscellaneous group in 9%of cases. Mortality recorded in this study was mainly due to septicaemia and multiple organ failure. Educating parents and guardians on the availability and safety of surgical care in children willencourage early presentation and reduce complications and mortality. Health care providers must recognize their limits and refer cases early to specialist pediatric surgeons. Government should enact laws that will cater for the rights of children and should also fund pediatric surgical care facilities.