Laparoscopic appendectomy is appropriate for virtually all patients and is preferred in obese patients, who require longer open incisions with increased manipulation and the resultant increase in surgical-site infections. The laparoscopic technique is also indicated in females, especially during the reproductive years, when tubal and ovarian pathology may mimic appendicitis. Laparoscopy not only provides direct observation of the appendix but also allows evaluation of all intra-abdominal organs, especially those in the female pelvis. Laparoscopic appendectomy has been shown to be as safe as open appendectomy in the first trimester of pregnancy; however, there is always risk to the fetus with any anesthesia or operation. Later or third-trimester pregnancies as well as any process that creates intestinal distention will make entering the intraperitoneal space more difficult and leave no room for maneuvering the instruments for a safe operation. Finally, laparoscopic appendectomy results in less incisional pain after surgery, allows a faster return to normal function or work, and produces a better cosmetic result.