Despite advances in surgical care for emergency surgery patients, complications and mortality remain high in this population. As an adjunct to surgical decision-making, surgical risk calculators have been developed and incorporated into the clinical environment in an attempt to better anticipate this surgical risk and as tools to discuss possible outcomes with families. Traditional risk calculators used in the field are linear and additive, with the same data fields incorporated for each patient every time. Clinically, however, surgical risk is not linear, and artificial intelligence (AI)-based risk calculators offer the ability to digest large amounts of patient data to predict outcomes and complications in a way that adapts to each individual patient’s risk factors. In this chapter, we will provide an overview of AI-based risk calculation for emergency surgery, including the data behind available risk calculators, their performance in particular populations, the issue of bias, and how these calculators compare to surgeon gestalt.