Acute abdominal pain in pregnant patients is a common reason for emergency consultation. Diagnosis is particularly difficult because of misleading factors related to normal pregnancy. Ultrasonography (US) in the evaluation of these patients is the first choice; the absence of radiation and side effects to the fetus allow its use without contraindications. However, the evaluation is limited by the normal anatomy alterations due to the displacement of the intra-abdominal structures, requiring greater skill of the operator and results are often uncertain. Given this scenario Magnetic Resonance Imaging (MRI) plays an increasingly important role, the absence of ionizing radiation and evidence of fetal harm, has allowed it to be incorporated as a tool when there is diagnostic uncertainly. This becomes especially important in suspected surgical pathology, acute appendicitis being one of the most common. MRI enables its identification as well as its differential diagnoses.