Acute epiploic appendagitis is rarely confirmed cause of abdominal pain. In most of cases it is a self - limiting disease with a benign course. It is an inflammation of the epiploic appendix (lat. appendix epiploica) of the colon. This disease mimics acute abdomen, starts as a sudden onset well-localized sharp pain of the abdomen, usually in the lower abdominal quadrants. In the majority of the cases, symptoms like high fever, nausea, vomiting, diarrhea, obstipation, loss of appetite are mild or not present. During clinical examination characteristic signs for acute appendicitis or diverticulitis can be positive. Inflammation parameters are within normal limits or slightly elevated in the majority of cases. Patients who have increased BMI or have recently lost weight are more susceptible to acute epiploic appendagitis. Epiploic appendagitis can be primary or secondary. Primary epiploic appendagitis is caused by infarction of the epiploic appendix as a result of the torsion of the appendix or due to thrombosis of a draining vein. Secondary epiploic appendagitis occurs due to an inflammatory process in a neighboring organ. The diagnostic modality of choice for the acute epiploic appendagitis is a CT scan. It is successfully treated conservatively with non - steroidal anti-inflammatory medications and intravenous fluids. An alternative option of treatment is a laparoscopy which should be avoided and used only in case of recurrent inflammation. Appropriate diagnosis of this rare disease is important in order to avoid unnecessary surgical intervention and its possible complications, speed up the recovery of the patient and save healthcare fundings.