Despite the availability of ultrasound, CT scans, and MRI, plain X-rays of the abdomen are still routinely performed. Plain films are a basic investigation which can provide a direction to the thought process. Before the availability of ultrasound and CT, plain films of the abdomen were highly rated and many times sufficient enough to prompt surgical intervention, especially in patients of perforation with free intraperitoneal air. Radiologists who could interpret the plain films correctly were held in high esteem. Plain film interpretation is like solving a jigsaw puzzle. Correctly interpreted X-rays save time and costs to the patient. However, not every disease can be diagnosed by plain films alone. If it were so, then other techniques would not have been necessary. Therefore, a realistic approach has to be adopted and one should make the best possible use of X-rays before reaching out to other investigations.