The usual presentation in school-age children is sudden paroxysmal abdominal pain that lasts at least 6 hours and continues to worsen, combined with fever. The child refuses to eat, is lazy, and is afraid of pressure on the abdomen, often accompanied by vomiting. Smaller infants cannot describe the pain and show paroxysmal crying, always with an irritable expression, no smile, and fear of pressure on the abdomen. Careful mothers often find that their children cry more when they are “tapped to sleep”, and persistent fear of pressure in the abdomen for more than 6 hours should be considered appendicitis, or at least observed as an emergency. The diagnosis of acute appendicitis is made when the abdominal examination focuses on the presence of fixed pressure pain in the right lower abdomen. The older child should be guided to cooperate in repeatedly checking the right lower abdominal tension and pressure pain, especially the right lower abdominal percussion pain and throbbing tremor. The diagnosis can be confirmed by paying attention to the child’s natural activities such as climbing up and down the consultation table, walking, squatting and other movements with speed and sensitivity. infants and children under 3 years of age can only rely on objective abdominal examination, comparing left and right, upper and lower ministries with simultaneous pressure and observing different responses. If there is still difficulty, a laparotomy can be performed in the right lower abdomen. Appendicitis can be diagnosed by the presence of pus, and an enlarged appendix may be seen on ultrasound. CT and MRI are also helpful but unnecessary and a waste of time. Children with suspicious disease can be observed or undergo immediate laparoscopy, and those with positive findings can undergo simultaneous microscopic or open surgery. Blood and urine tests are for reference only and have little significance in confirming the diagnosis.