Background <p>This study investigated the feasibility and challenges of app-based follow-up after major emergency abdominal surgery. The increasing use of digital health presents great potential benefits for both patients and the healthcare system. This study aims to identify barriers to and requirements for implementing digital solutions, seeking to increase inclusion and response rates.</p> Methods <p>A&#xa0;controlled before-and-after study was conducted from April to November 2023. The intervention bundle included dedicated staff, app installation guidance, involvement of relatives, and reminders. Three electronic questionnaires were sent to patients on postoperative days&#xa0;14, 30, 90, and 180. The primary outcome was the feasibility of app-based follow-up, measured by inclusion and response rates at each timepoint.</p> Results <p>A&#xa0;total of 206 patients were included, 142 in the before group (control) and&#xa0;64 in the after group (intervention). The intervention bundle resulted in a&#xa0;relative increase of 57.9% in the inclusion rate and of 40.5% in the response rate. The first of the three questionnaires was generally the most answered.</p> Conclusion <p>App-based follow-up after major emergency abdominal surgery is feasible but requires dedicated efforts and a&#xa0;bundled approach.</p>