Purpose/Introduction: Right upper quadrant (RUQ) pain is a common emergency general surgical presentation. Ambulatory Care Pathways (ACP) are described management strategies to reduce hospital bed pressure. It allows well patients presenting out of hours to be discharged from the emergency department, with a plan for re-presentation the following morning for further management. The aim of this study is to demonstrate that selected patients with RUQ pain can be managed via ACP to achieve shorter inpatient length of stay (LOS) without higher morbidity or mortality. Methodology: Data on patients treated through the ACP for RUQ pain was prospectively collected from June 2021 to June 2022 and compared with a retrospective matched cohort of patients eligible for ACP management between June 2019 and 2020. Data collected included patient demographics, diagnosis, LOS and complications, including readmissions within 30 days. Results: Patients on the ACP had significantly shorter LOS (p< 0.001) with a median LOS of 1.0 (IQR 0.0-1.30) compared to retrospective group with a median of 2.0 (IQR 1.25- 2.75). There were no significant differences in patient demographics, theatre access, surgical complications, or readmissions within 30 days. Conclusion: Patients who presented out of hours with RUQ pain treated through the ACP had a shorter LOS without increased morbidity or mortality. ACP management of RUQ pain appears safe for patients who meet strict criteria.