Appendectomy is the most common treatment for acute appendicitis and has been used for many years; however, we have clinically found that some patients who underwent appendectomy in primary care hospitals were not relieved or continued to get worse after surgery and were transferred to large hospitals for further treatment, only to find that the diagnosis was incomplete or wrong; there were even cases of patients dying after appendectomy in primary care hospitals. The reason is that although appendicitis is a common disease, it is easily confused with other acute abdominal diseases; coupled with the small incision of traditional appendectomy, it is difficult to fully explore the abdominal cavity during the operation; some acute abdominal diseases, because of the inflammation of the appendix, seem to be correctly diagnosed by the operator and operate without errors, but in fact, it is a case of “peeking through the tube”, which will lead to serious consequences. We carefully observe and compare conventional appendectomy and laparoscopic appendectomy. Although the technical content of laparoscopic appendectomy is small, it allows a comprehensive intraoperative exploration of the pathology in the abdominal cavity and can overcome the serious adverse consequences that may occur with open appendectomy due to insufficient exploration. In addition, laparoscopic appendectomy is much less invasive than open surgery; the chance of incisional infection and incisional hernia is almost zero (compared to the few cases of postoperative wound infection and incisional hernia due to infection spread to the wound during acute appendicitis surgery). When comparing the two surgical approaches, laparoscopic appendectomy has many advantages.