ABSTRACT Objectives: This study aimed to determine the patterns of sonographic findings in patients with lower abdominal pain in Nnewi metropolis, Anambra State, Nigeria. Materials and Methods: This was a retrospective cross-sectional study, which involved 381(267 males, 114 females) conveniently selected sonographic examinations done due to lower abdominal pain at Waves Diagnostic Centre in Nnewi metropolis, Anambra State, Nigeria from January 2018 to August 2021. Data on age, gender, clinical indications and sonographic imaging findings were collected from the archives and analyzed using both percentage and Pearson's correlation test. The level of statistical significance was set at p < 0.05. Results: Out of 381 cases 175 (45.94%) had normal sonographic findings. Abnormal findings accounted for 206(54.06%) as follows: pelvic inflammatory disease,45(11.8%) uterine myoma 37(11.6%), caecal cancer, tubo-ovarian abscess, mucinous cystadenoma, hernia, cervical cancer, polmetra,1(.3%) each. Out of 175 normal sonographic findings, 160(91.43%) were females while males accounted for 15(8.57%). There were positive, non-significant correlations between normal findings with gender (r= 0.112, p = 0.93), age (r= 1.21, p= 0.99) and indications (r= 0.335, p= 0.051). There was a negative non-significant correlation between pathological findings with gender (r= - 0.05, p= 0.65). Positive significant correlation existed between pathological findings and age(r= 0.163, p= 0.001), and clinical indication (r= 0.282, p= 0.000). Conclusion: The most affected were females especially those within the age group of 51-60 years. Pelvic inflammatory disease was the commonest pathology.