Purpose: Abdominal surgical emergencies are a major health burden in low- and middle-income countries where management is often very challenging, and associated with high morbidity and mortality. The spectrum, management, and outcomes of abdominal surgical emergencies needs to be updated.Methods: This was a hospital-based retrospective cross-sectional study carried out in Bamenda, Cameroon over a 2-year period. Records of patients who met the inclusion criteria were reviewed, with pre-, intra- and postoperative data collected and analyzed.Results: There were 207 patients included in this retrospective review (male to female ratio of 1.4:1. The mean age was 47.4 (± 19.4) years. Intestinal obstruction (34.8%) and perforated peptic ulcers (15.5%) were the most common abdominal surgical emergencies. The median delay and interquartile range to presentation and in-hospital delay were 6 (4) days and 8 (12) hours, respectively. The mean length of hospital stay post-surgery was 11days. There were 48.3% of patients who developed a complication; 34.78% were major, 17.9% had an unplanned reoperation, and 15 (7.2%) were readmitted after discharge. The 30-day in hospital mortality was 19.8%. Mortality was independently associated with a high American Society of Anesthesiologists (ASA) score; ASA score > 3, age > 60 years, and referral from other health facilities.Conclusion: Intestinal obstructions from intraperitoneal neoplasm is the most common cause of abdominal surgical emergency in North West Cameroon. Abdominal emergencies here are associated with a very high morbidity and mortality in males > 60 years with an ASA score > 3 and with more than one comorbidity.