Purpose Emergency surgery represents an important and critical component of surgical care. Time to Theatre (TTT) is a key performance indicator for theatre efficiency. NSW emergency surgery guidelines and principles for improvement have recommended 6 categories regarding timing of emergency surgery based on the clinical urgency. The aim of this study was to determine if the recommended urgency categorization has been implemented. Methodology We performed a retrospective review of 552 Acute Surgical Unit (ASU) cases at a single hospital that were performed between January 1, 2023 to October 30, 2024. Data regarding type of procedure, time of booking, category, theatre check-in time and procedure start time were collected. Results Life threatening patient (Cat A) had a wait time of 38 minutes. Highly critical (Cat B) patients had an average wait time of 87+/- 21 minutes with 78% cases performed within the timeframe while for Critical (Cat C) patients it was 189+/-15 minutes with 71.5% started within time. For category D and E patients these figures were 277+/-239 minutes and 61% and 744+/-408 minutes and 73% respectively. All the non-urgent cases were started on time. Conclusion The more urgent cases had more chances of surgery being performed within the timeframe than the less urgent cases. Although the cause of delay was not entered into the system, access to the emergency theatre is the most possible reason for delay in cases. Prospective, larger study analyzing reasons of delay and its impact on clinical care of patients is needed.