ABSTRACT Introduction: Laparoscopy can diagnose and treat the etiologies of acute upper abdominal pain. This study aimed to assess the effectiveness of laparoscopy in upper gastrointestinal (G.I.T) emergencies regarding intraoperative and postoperative outcomes. Method: A retrospective observational study was conducted in the emergency departments of Zagazig University on 215 patients who had upper abdominal emergency surgeries between June 2017 and June 2020. Results: The majority of patients (68%) were 40 years old, with a male predominance (67%). Acute cholecystitis (54%), perforated peptic ulcer (PU) (18%), splenic injuries (26%), and acute pancreatitis with necrosis (2%) were the most common reasons for surgical upper G.I.T. emergencies. Intraoperative complications occurred in 10 cases(5%) in the form of omental bleeding (2%), cystic artery bleeding(1%), liver injuries (0.5%), injury to the duodenum (0.5%), injury to the colon (0.5%), and bile duct injury (0.5%). Intraoperative conversion occurred in 10 patients (5%), with the most common reasons being uncontrolled bleeding (2%), obstructed anatomy or difficult dissection (1%), difficult closure of perforated peptic ulcer (0.5%), duodenal injury (0.5%), colonic injury (0.5%), and bile duct injury (0.2%). Postoperative complications occurred in 41 patients(20%) in the form of wound infection (5%), hematoma (3%), ileus (2.5%), seroma (2%), pneumonia (1.5%), and intra-abdominal abscess formation (1%), omental bleeding (1%), adhesive IO (1%), cystic duct stump leakage (1%), biliary stricture (0.5%), port site hernia (0.5%), port site bleeding (0.5%), and cystic artery stump bleeding(0.5%). Re-intervention occurred in 9 patients (4.5%), with a mortality rate of 1.5%. Conclusion: In upper G.I.T. emergencies, the laparoscopic approach is safe and feasible, with good intraoperative and postoperative outcomes.