Appendectomy is the most common surgical procedure done worldwide. 8 The management of simple appendicitis is straight forward. Its appendectomy, either open or through laparoscopy. Complicated appendicitis was traditionally managed with immediate surgery. But in 1980 conservative management was described. As per this approach, patients with complicated appendicitis were initially treated with intravenous antibiotics followed by interval appendectomy after a period of 4 to 16 weeks. Over the years this approach gained popularity. But in recent years this practice has been questioned with new data. The objective of the present study was to evaluate the surgical treatment of appendix. The study was planned in the 20 cases in IGIMS, Patna from Jan 2008 July 2008. The patients were Clinically diagnosed case of Acute Appendicitis presenting within 48 hours of initiation of Abdominal pain. On all patients Open appendicectomy was done. Preoperative prophylactic antibiotics were given (cefotaxime 500 mg and metronidazole 250 mg intravenous) and continued post operatively for 3 days. Patients were discharged with oral Amoxcillin 250 mg 12 hourly and metronidazole 200 mg 8 hourly for 5 days. The diagnosis and management of acute appendicitis have been described with a focus on some current issues. Appendicitis is the most common surgical condition. Complicated appendicitis is associated with high morbidity. High leucocyte count, delayed presentation and appendicolith are possible markers of complicated appendicitis. Controversy exists about the ideal time for surgery in complicated appendicitis. Early surgery in complicated appendicitis is safe, feasible.