Appendicitis and lower gastrointestinal emergencies represent the majority of emergency presentations to acute general surgical on-call teams. Early recognition and resuscitation of the patient as well as prompt investigation allow appropriate management plans to be initiated in a timely manner. Those patients requiring operative intervention should be managed within a multidisciplinary team to achieve optimal outcomes. Current surgical approaches favour minimally invasive techniques, where appropriate, with decreased pain and shorter length of stay being major advantages.