Abstract Background: The most common emergency for surgery in the population is acute appendicitis. Though laparoscopic appendectomy is widely performed today, the advantages of laparoscopic versus open appendectomy remain under contro-versy. Aim of Study: To determine whether Laparoscopic Ap-pendectomy (LA) is better than thetraditional Open Appen-dectomy (OA). Patients and Methods: It is a prospective study, involving 150 patients with acute appendicitis. All patients undertook abdominoal and pelvic ultrasonography, to exclude any con-comitant gynecological finding and other cause for right iliac fossa pain. The patients were admitted to in Al-Zahraa University Hospital and Kobry El-Koba Military Hospital during the period from November 2017 to November 2019. Operational time, post-operative pain, first bowel movement, hospital stay, early work return and post-operative complications were compared in patients with open versus laparoscopic appen-dectomy. Results: OA and LA were performed in 150 patients (75 patients for each procedure). The laparoscopic technique gave less length of hospital stay (p=0.025), better in operative time, short hospital stay, low visual pain analogue range, first bowel motion recorded and early return to normal activity (p < 0.01), less intraoperative and post-operative complications 6.7% of all patients had complications post-operatively all in open group. Conclusion: The advantage of laparoscopic appendectomy is decreased pain following surgery, a short hospitalization, and an early return to work. Laparoscopic appendectomy should be recommended for acute appendicitis as an effective and safe procedure.