Background: Acute appendicitis (AA) is the most common surgical disease with a lifetime risk of 7–8%.Traditionally, appendectomy has been the treatment of choice for acute appendicitis. Mortality rate after appendectomy is very low and may range from 0.07 to 0.7% rising to 0.5 to 2.4% in patients without and with perforation. Over 250,000 appendectomies are performed each year in the USA alone.It was observed during the outbreaks of influenza and Middle East Respiratory Syndrome (MERS) in 2012 , that referrals for non-respiratory causes decreased significantly as the epidemics progressed. An outbreak of respiratory disease should not by itself affect the incidence and presentation of acute appendicitis. Nevertheless, we have noticed in our institution that as the COVID-19 pandemic spread in our community there was a significant decrease in the number of cases of acute appendicitis presenting to the ED of our institution and an increase in the number of admitted patients of AA requiring surgery. Objectives: To compare the incidence and presentation of aute appendicitis before and during the COVID-19 lockdown period.Also, to compare thepercentage of patients requiring operative management, intraoperative findings and postoperative complications before and during the COVID-19 pandemic for cases of acute appendicitis. Methodology:This prospective observational cohort study was undertaken at Government Medical College Baramulla which is a 300 bedded teaching hospital catering as a referral institute for a catchment population of roughly 1.2 million. All consecutive patients of clinically or radiologically diagnosed AA admitted between 25th March and 25th July were included in this study (corresponding to complete lockdown in our country). This was designated as group A. Data was also collected from hospital records of all acute appendicitis patients admitted in the corresponding months of 2019 i.e from 25th March 2019 to 25th July 2019 and analysed for comparison and designated as group B Results: A total of 169 Cases of Acute appendicitis were evaluated: 52from the lockdown period i.e Group A and 117 from the non-pandemic period i.e Group B. No statistical difference in the male: female ratio and demographic pattern was observed. Duration of pain preceding admission in Group A was 57.6+_8.16 hours and 36.55+_7.81 hours in Group B and was statistically significant. It was observed that during COVID lockdown about 69.23% (36) patients had a delayed presentation compared to 20.51%(24) in group B. In Group A, 26.92% (14) patients were managed conservatively and 73.07% patients were operated. InGroupB47.86% (56)patients were managed conservatively and 52.13%(61)patients underwent operative management. Conclusion: This COVID‐ 19 pandemic has forced a paradigm change in all aspects of patient management worldwide and while the focus continues to remain on control of the virus, there are serious apprehensions over the effects on non‐ COVID patients especially surgical emergencies and malignacy patients. This message needs to reach far and wide in the community, so that the incidence of late presentation of surgical emergencies to ED’s, with acute appendicitis being the commonest one is prevented.