Introduction: An emergency laparotomy is a lifesaving procedure undertaken mostly in acute cases without much preparation of the patient. Despite being one of the most common urgent surgical procedures, it still proves to be a challenge for the surgeons of the world. Objective: To find out the post-operative complications and outcome of non-traumatic emergency laparotomy. Methods: This prospective study was carried out in 200 patients different surgery units of Dhaka Medical College Hospital with an initial diagnosis of acute abdomen of nontraumatic origin who underwent emergency laparotomy to evaluate different causes of laparotomy and the morbidity & mortality associated with it. Acute abdominal pain was the constant symptom with different degree of severity, presenting either locally or diffusely. In conditions with peritonitis either local or diffuse, muscle guarding, rigidity or diminished bowel sound were found. PlainX-ray abdomen was the most frequently used investigation alone with blood count, serum amylase and ultrasonogram of abdomen. Clinical diagnosis was made depending on clinical findings and the results of investigations. Results: Two hundred cases of nontraumatic emergency laparotomy patients werestudied in Dhaka Medical College Hospital during the period of July 2007to June 2008. The peak age incidence was found in the third decade of life (34%). Overall male-female ratio was 2.3:1, but there were disease specific variations. Age ranged from 12 to 75 years. Most of them were in the age group of 10 to 50 years of age. Most common operation performed was appendectomy, 74 cases. Next repair of duodenal ulcer perforation and thorough peritoneal toileting, 46 cases. After Appendicectomy 5.94% of the patient had complication. In case of duodenal ulcer perforation 17.65% had post-operative complication. Post-operative complication among the patients of resection and anastomosis of small gut perforation was 16.66% and for resection and anastomosis of sigmoid volvulus was 16.66%. Early post-operative complication ranges from minor chest infection to death of the patient. Commonest post-operative complication was wound infection. Some of the patients developed more than one complication. Out of 200patients most of them were case of acute appendicitis and under wentappendicectomy. Six patients (3%) died postoperatively. Conclusion: Post-operative complications are more common after emergency laparotomies. Maximum complications were found in patients of delayed presentation or in patients having any associated co morbidities. Therefore early detection, immediate intervention with better postoperative care can minimise the postoperative complications. The present study suggests that proper awareness among rural populations, adequate health education to seek prompt medical aid, a good referral and efficient transportation can reduce the delayed presentation which in turn will prevent postoperative complications following emergency laparotomy.