As we all know, voluminous writings have appeared since the pioneer work of Reginald Fitz3 and Charles McBurney8 concerning the early diagnosis of appendicitis, and little has been added. In this paper we will not append to these volumes. Although the mortality from appendicitis has been reduced greatly during the past quarter of a century, we are still plagued with a significant morbidity. This study was undertaken to reevaluate the therapeutic approach to appendicitis and more specifically appendicitis complicated by: (1) generalized peritonitis with perforation, (2) generalized peritonitis without perforation, and (3) localized abscess formation. Methods whereby postoperative complications might be reduced will also be considered. A review of patients undergoing appendectomy at Children's Hospital, Louisville, over a five-year period ending Dec 31, 1962, was undertaken. In this period there was a total of 580 patients upon whom appendectomy was performed. Ninety of these were incidental to other