Aims: Conduct a systematic review of case reports and case series regarding the development of acute abdomen following vaccination with COVID-19, to describe in detail the possible association, the clinical and demographic characteristics. Methods: Case report studies and case series regarding the development of acute abdomen following COVID-19 vaccination were included. Systematic review studies, literature, letters to the editor, brief comments, etc. were excluded. PubMed, Scopus, EMBASE, and Web of Science databases were searched until June 15, 2023. The Joanna Brigs Institute tool was used to assess risk of bias and study quality. Descriptive data were expressed as frequency, median, mean, and standard deviation. Results: Seventeen clinical case studies were identified and 17 patients with acute abdomen associated with COVID-19 vaccination were evaluated, including: acute appendicitis (n=3), acute pancreatitis (n=9), diverticulitis (n=1), cholecystitis (n=2) and colitis (n=2). The most associated COVID-19 vaccine was Pfizer-BioNTech (mRNA) with 64.71 %. The majority of cases acute abdomen was after the first dose (52.94 %). All patients responded objectively to medical (88.34 %) and surgical (11.76 %) treatment and were discharged within a few weeks. There were no cases of death. Conclusions: Acute abdomen is a rare complication of great interest in the medical and surgical practice of COVID-19 vaccination, our study reviewed based on a small sample of patients, therefore it is recommended to conduct future observational studies and fully elucidate the mechanisms by which this association occurs.