Surgical emergencies account for a major part of the surgeon's workload. Evaluation of pattern of surgical emergencies will assist in developing concrete proposals for improved care. The aim was to assess the pattern of surgical emergencies in our center.We undertook one-year prospective study of all the emergency surgical admissions at Federal Medical Centre Makurdi from January to December 2011.There were 575 surgical emergencies which constituted 56.8% of surgical admission, and 27.2% of allemergency hospital admissions. The commonest trauma cases were soft tissue injuries (30.3%), while the commonest non-trauma case was acute abdomen (41.6%). The mean age of the patients was 33.7 ± 17.2 years. Multiple injuries and traumatic brain injuries requiring intensive care monitoring, and malignancies were associated with higher mortality rates (p = 0.001). The 1-year mortality rate was 7.8% and the preventable death rate (PDR) for the trauma-related emergencies was 71.4%.There is a wide spectrum of surgical emergencies in our setting with trauma accounting for a substantial proportion of cases. Improved trauma care, neurosurgical services and intensive care facilities may improve the outcome of surgical emergencies in our environment.