Background:Appendicitis is most frequently seen in patients in their second and third decades of lifebut it is quite rare in the young age, probably because the configuration of the appendix at this age makes obstruction of the lumen unlikely. There is a rough parallelism between the amounts of lymphoid tissue in the appendix and the incidence of acute appendicitis. The aim of the present study was toevaluate intra-operative difficulties and operative time in laparoscopic method versus open Appendectomy. Toassess post-operative bowel movement recovery, start of oral intake, resuming physical activity, length of hospital stay and analgesia use frequency in adults with complicated appendicitis.Patients and methods:A prospective cohort study was conducted on 26 adult patients with complicated acute appendicitis. Patients were divided into 13 patients for laparoscopic appendectomy (LA) and 13 patients for open appendectomy (CA) at Emergency unit of General surgery department ofZagazig University Hospitals. Before treatment, all patients were evaluated clinically by using "the modified Alvarado score", laboratory investigations and radiological investigations. Results: We found that the mean operating time in laparoscopic appendectomy was shorter than that in the open approach. The overall post-operative complications were lesser in laparoscopic group. The incidence of wound infection was in open group (15.4%). This finding supports the current surgical dogma that early treatment for appendicitis by laparoscopy is the best practice, to prevent further inflammation of the pelvis by removing the source of infection. Conclusion: LA constitutes a safe and feasible procedure for the treatment of CA. In the case of CA, endobags and endostapler should be used or the appendiceal stump should be inverted after applying Roeder knots.