Abdominal pain remains a common complaint in children and adolescents and accounts for a frequent number of visits to pediatricians as well as gastroenterologists. A thorough understanding of the neuroanatomy and neurophysiology of the abdomen and its contents is immensely important in understanding the origins of abdominal pain and formulating a limited differential diagnosis for the patient presenting with abdominal pain. With this as fundamental background, and the important clues provided by a thorough history and physical examination, a rapid and accurate diagnosis for the pediatric patient presenting with either acute, subacute, or chronic abdominal pain can be in most instances reasonably ascertained. Subsequently, specific studies for confirmation can then be performed and appropriate treatment implemented. The tremendous advancement in the field of gastroenterology provided by the continued development of endoscopic procedures has allowed for precise identification of many GI disorders. Endoscopy in concert with radiology procedures can be used effectively now to adequately establish a diagnosis in almost all patients presenting with abdominal pain.