Abstract Background: Intra-abdominal pressure (IAP) has recently been recognized as a new vital sign in critically ill patients. Microwave reflectometry has been proposed as a potential approach for non-invasive IAP measurement. However, systematic investigation on how individual anatomical and geometric factors influence changes in the microwave reflection response of the abdominal compartment is limited. Complementary information regarding illumination frequency and specific absorption rate (SAR) also warrants consideration. Objective: This study aimed to advance the current knowledge on using microwave radar-based sensors in IAP monitoring by studying the most influencing factors. The penetration depth and spot size versus radiation frequency is studied as well. Information on energy deposition due to radio-frequency exposure is investigated too. Methods: Numerical simulations were performed using abdominal models adjusted to represent different IAP levels. Reflection signal features were analyzed in relation to IAP-induced changes, and SAR was calculated using human models. Subsequently, a radar sensor prototype was tested on a benchtop abdominal phantom. Lin’s concordance correlation analysis was used to evaluate absolute agreement between radar-estimated IAP and reference IAP. Additional statistical analyses assessed bias, precision, concordance, and risk levels. Results: Sagittal abdominal diameter was the dominant factor affecting the microwave reflection response. Reflection amplitude showed a periodic trend consistent with abdominal displacement corresponding to multiples of half-wavelength values of the applied electromagnetic waves. Numerical SAR simulations showed increasing SAR with frequency while remaining below the applicable exposure limits under the investigated conditions. The radar sensor showed a bias of 0.43 mmHg and a precision of 2.55 mmHg. Concordance analysis among the paired changes remaining after application of the predefined exclusion criteria showed agreement in the direction of IAP change. Conclusion: The present study should be considered a preliminary proof of concept. Clinically, the technology is currently more suitable for early warning and trend monitoring than for precise absolute IAP measurement, and it does not yet replace standard intravesical measurements. Its ability to support clinical decision-making, including guiding fluid therapy, requires prospective validation in patients. Keywords: transient microwave reflectometry; intra-abdominal pressure; non-invasive measurement; numerical simulation; phantom testing