It is generally agreed that the ultimate elimination of appendicitis as a cause of mortality lies in early diagnosis plus prompt and adequate surgery. In spite of universal acceptance of this dictum, just short of 5000 persons died of perforated appendicitis in the United States last year. This study deals with a series of 391 cases of perforated appendicitis without mortality, 305 being operated upon by us and 86 by other surgeons using our exact technique of treatment. During the same period covered by this study, 104 cases of perforated appendicitis were operated on in another hospital in our community with eight deaths, a mortality of 8%. This presentation in no way deals with the diagnosis of acute appendicitis per se but rather with the management of perforated appendicitis and the myriad of problems involved in the successful prosecution of its treatment. In the year 1930, a total of 18,000