Laparoscopy reduces the risk of performing unnecessary appendectomies and offers the advantages of minimal invasive surgery when appendectomy is needed. We report our experience comparing open (Group A) with laparoscopic (Group B) appendectomy.There were 20 patients in each group. Age, sex, signs, symptoms, evolution, laboratory, stage of disease, drains, duration of surgery, antibiotics, oral intake restart, postoperative pain at 24, 48 and 72 hours, complications, hospital stay, return to normal activities and cosmesis were reviewed. Statistical differences were determined using Student's t test (two tailed) or chi-square with Yates correction. Surgical technique is described.In both groups most variables were similar (p = ns). Group B presented earlier oral intake restart (p < 0.001), and less postoperative pain at 24 (p < 0.001), 48 (p < 0.01) and 72 hours (p < 0.001). Hospitalization stay was shorter (p < 0.001) and return to normal activities was earlier (p < 0.001) in group B. Better cosmetical appearance was observed in Group B (16 vs. 0 "excellent" -p < 0.001).Laparoscopic approach may reduce unnecessary appendectomies and it allows to perform appendectomy in a safe and effective way. In this study, laparoscopic was better than open appendectomy regarding early restart of oral intake, less postoperative pain, shorter hospitalization stay, earlier return to normal activities and better cosmetic appearance.