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• We audited our recent experience with diagnostic laparoscopy performed over a 30-month period on 131 consecutive patients. Laparoscopy was 100% accurate in the diagnosis or exclusion of intra-abdominal malignant neoplasms, and future care decisions were affected by this information. Laparoscopy in the evaluation of chronic abdominal pain yielded positive findings in 47% of cases. The majority of referrals (73%) for the investigation of chronic abdominal pain came from the medical services, whereas the majority of referrals (72%) for the investigation of cancer originated from surgeons. Laparoscopy in the setting of acute abdominal pain yielded useful information that affected patient outcomes in 71% of cases. There were no serious complications in this series. Laparoscopy is a safe and useful diagnostic tool, especially for the diagnosis, staging, or exclusion of cancer.(Arch Surg. 1992;127:379-383)