Abstract: Objective To summarize the clinical characteristics of abdominal epilepsy (AE) so as to improve clinical diagnosis. Methods Clinical data about an adult patient with abdominal epilepsy who was misdiagnosed as acute appendicitis and underwent surgery referred to our hospital in December 2017 were retrospectively analyzed and its relevant literatures were reviewed. Results The patient was a 55-year-old female. She admitted to emergency department because of abdominal pain for 1 month, aggravating for 1 week and bloody stool for 1 day. On examination, she presented with abdominal muscular tension, full abdominal pain with sharp pain in right lower abdomen and no rebound pain. She had a history of viral encephalitis. Diagnosis of acute appendicitis was made in the local hospital and appendectomy was performed. However, the abdominal pain was not alleviated after operation. She referred to our hospital for further treatment. A 24- hour dynamic EEG was performed and sharp waves and slow waves were found, then the patient was diagnosed as adult abdominal epilepsy. The pain was relieved after anti-epileptic treatment. Conclusion Adult abdominal epilepsy is rare. For patients with long-term repeated abdominal pain, when common acute abdominal pain is eliminated, abdominal epilepsy should be considered, and dynamic EEG can be helpful in diagnosis in time. Empirical anti-epileptic treatment should be given when necessary.