A-035 16 In this lecture, the role of imaging in the evaluation of gynaecological emergencies will be presented. A combined approach using both clinical findings and imaging features is necessary. Accurate evaluation is important as failure to make a diagnosis may lead to serious consequences. Presenting symptoms, such as pelvic pain or vaginal bleeding or discharge, may overlap with pregnancy-related emergencies and with non-gynaecological abdominal emergencies. The range of conditions to be considered includes ovarian cyst emergencies (cyst rupture, haemorrhage or torsion), infective conditions (Bartholins' or vulval abcess, pelvic inflammatory disease or tubo-ovarian abcess) and acute bleeding (from inflammation, neoplasm, or trauma). Pain may be related to the menstrual cycle, as in endometriosis or ruptured corpus luteum, or may be unrelated, such as in fibroid or ovarian torsion or pelvic inflammatory disease. The imaging features of these acute abnormalities will be reviewed and discussed in the context of the differential diagnoses.