Emergency cases, especially in surgery field, are still a major problem globally, therefore, health centers have to provide a better preparation to face such cases. This was a retrospective descriptive study. This study was aimed to obtain the profile of the 10 major cases in emergency department of surgery from January to December 2015 at Prof Dr. R. D. Kandou General Hospital. The results showed that the case distribution was predominated by non-traumatic case (70.13%), males (64.45%), and age group of 45-64 years (33.05%). The major cases registered in Emergency Department of Surgery was 1) epidural haematome (3.55%), followed by 2) subarachnoid haemorhage (2.45%); 3) injuries of thorax and intrathoracal organs (1.95%); 4) appendicitis (1.89%); 5) fractures of the shoulder and upper arm (1.68%); 6) sepsis (1.51%); 7) fracture of femur (1.45%); 8) injury of abdomen and intraabdominal organs (1.43%); 9) hernia inguinalis (1.18%); and 10) paralytic ileus and intestinal obstruction (1.12%). Conclusion: The majority of cases were males, aged 45-65 years, and non-traumatic cases,.Keywords: Emergency Department, surgery, major case Abstrak: Kasus gawat darurat khususnya di bidang ilmu bedah, masih merupakan masalah global. Oleh karena itu di berbagai pusat kesehatan yang telah mengetahui tingkat kejadian kasus kegawatdaruratan spesifik harus melakukan persiapan lebih baik. Jenis penelitian ialah deskriptif retrospektif untuk mendapatkan profil 10 besar kasus di Instalasi Gawat Darurat Bedah RSUP Prof Dr. R. D. Kandou periode Januari-Desember 2015. Hasil penelitian menunjukkan distribusi terbanyak ialah kasus non-trauma (70,13%), jenis kelamin laki-laki (64.45%) dan usia 45-64 tahun (33,05%). Penyakit terbesar tercatat di Instalasi Gawat Darurat Bedah ialah: 1) epidural hematom (3.55%); 2) perdarahan subaraknoid (2,45%); 3) cedera dada dan organ dalam dada (1,95%); 4) apendisitis (1,89%); 5) fraktur bahu dan lengan atas (1,68%); 6) sepsis (1,51%); 7) fraktur femur (1,45%); 8) cedera perut dan organ dalam perut (1,43%); 9) hernia inguinalis (1,18%); dan 10) ileus paralitik dan obstruksi intestinal (1,12%). Simpulan: Pada studi ini, mayoritas kasus ialah laki-laki, usia 45-64 tahu, dan kasus non trauma. Kata Kunci: Instalasi gawat darurat, bedah, kasus tersering