Intra -abdominal infection continues to defy advances in surgical care with considerable mortality. It is characterized by a spectrum of presentations of varying disease severity. The need to ensure standards for comparing studies and antibiotic trials on intraabdominal infection led to the emergence of several scoring systems. There is paucity of information on this subject in local literature, even though a Nigerian scientist pioneered one of the earliest stratification systems. This is a review of literature on one of the scoring systems that has made an impact in the standardization of intraabdominal sepsis:the APACHE II scoring system. This study will review the genesis, bedside application, uses, limitations and alternatives as a scoring system for intraabdominal infection. Over two decades of use, it is simple and continues to be a reliable indicator of severity of intraabdominal infection.