BACKGROUND: Minimally invasive surgery has evolved enormously in the last twenty years and now includes emergency laparoscopy for diagnostic and therapeutic procedures. METHODS: Review of the literature. RESULTS: The present-day operating room should be adapted to evolving laparoscopic techniques, as well as new intraoperative diagnostic and therapeutic modalities. The ergonomic and technical aspects of emergency laparoscopy include the surgeon’s and the patient’s position, the operating room setup including the table, the monitor, and the specific equipment; patient preparation adapted as necessary to potential changes and conversion; the trocar setup, ergonomical, adapted to the pathology. Variations of the above and specific needs are dependent on patient status, body build, and the pathology being treated. CONCLUSIONS: High-tech equipment and associated procedures have modified the needs for a modern operating room setup. Laparoscopic procedures for emergency surgery must make use of ergonomic principles.