Acute appendicitis is one of the most common surgical emergencies in the world and has some well-known signs and symptoms, like increased leukocyte count and right lower quadrant pain. However, these predictors are not constant and their accuracy is questionable. Hence, it is necessary to improve the accuracy of diagnosis of acute appendicitis to prevent negative appendicectomies. In this study, we suggest that calculation of the NLR may provide a sensitive parameter in the preoperative prediction of AA and may help preoperatively to differentiate complicated from non-complicated appendicitis. A total of 108 patients who came with complaints of right iliac fossa pain and clinically diagnosed to have acute appendicitis were considered. Clinical diagnosis was established by means of history, physical examination, laboratory investigations and radiological investigations. In our study, it was noted 5.6% of the patients’ histopathology showed a normal appendix, 59.3% showed acute uncomplicated appendicitis and 35.2% showed acute complicated appendicitis. NLR with a cutoff value of 3.17 was estimated to differentiate normal appendix and acute appendicitis with a sensitivity of 86.8% and specificity of 60%. The cut-off value for NLR to differentiate between acute appendicitis and acute complicated appendicitis was taken as 3.87, with a sensitivity of 84.2% and 63.9%