O&G is one of the broadest hospital-based specialties, encompassing medicine, surgery, and childbirth; so it is no wonder that O&G patients with a diverse range of symptoms present to the ED on a daily basis. The most common symptoms are PV bleeding, in both pregnant and non-pregnant females, PV discharge, and lower abdominal pain. The majority of these cases are benign and the patient can be discharged after reassurance and arrangement of primary care follow-up, but a few of them may have an underlying life-threatening condition. One classic example is a ruptured ectopic pregnancy. About 10% of females who present to the ED with PV bleeding or abdominal pain in the first trimester of the pregnancy have an ectopic pregnancy. Such patients may present in shock following a catastrophic haemorrhage in the abdomen or arrive at the ED well but collapse in the waiting room. Management of these emergencies requires establishment of IV fluid resuscitation, analgesia, and involvement of an O&G specialist. Such patients are often rushed to the theatre for emergency operation to control the haemorrhage. In other situations, the normal practice of taking a history and physical examination should be followed. Bear in mind that close attention to privacy and confidentiality is most crucial during the procedure. Interview the patient without the other family members if possible, as the patient may be reluctant to tell the whole story in their presence. Pelvic examination is sometimes painful, undignified, and embarrassing to many patients especially if the examining doctor is a male. This can be avoided to a large extent by explaining the process of examination, and performing it gently in the presence of a chaperone. It must not be forgotten that vaginal bleeding during pregnancy produces maternal distress, for which also the patient will need support. Patients presenting with lower abdominal pain often have a disease related to the female genital tract or the urinary system. But the lower GI tract may also contribute to the pain and should therefore be included in the differentials. With regard to the reproductive system, there are a few causes of pain during pregnancy.