Many people think of appendicitis when they have pain in the right lower abdomen. It is true that the Mai’s point in the right lower abdomen is the anatomical location where the appendix is located, and the typical symptom of appendicitis is metastatic right lower abdominal pain, which is usually persistent and intensifies paroxysmally, with local pressure points, so people often think that right lower abdominal pain is appendicitis. However, the etiology of right lower abdominal pain is multifaceted, and appendicitis should not be the only cause. The most common clinical confusion with appendicitis is ureteral stone on the right side. Ureteral stone pain is usually more intense, accompanied by hematuria, low back pain and percussion pain in the kidney area, and can be clearly diagnosed with urological ultrasound, plain film or CT examination. Pain in the right lower abdomen must be differentiated from gynecological diseases in female patients, especially in women of childbearing age. Ectopic pregnancy in the right fallopian tube, right ovarian corpus luteum rupture, right ovarian cyst torsion, right adnexitis and pelvic inflammatory disease can all cause right lower abdominal pain. Therefore, it is necessary to consult a gynecologist when a female patient presents with right lower abdominal pain. Some gastrointestinal diseases, such as upper gastrointestinal tract perforation and gallbladder perforation, may also cause pain in the right lower abdomen due to the flow of digestive fluid or bile to the right lower abdomen along the paracolic sulcus of the ascending colon, and may show signs of peritonitis, which can be easily misdiagnosed as appendicitis. If exploratory surgery is performed it is best to choose laparoscopic exploration so that diagnosis and treatment can be performed in a minimally invasive procedure. In addition, right lower abdominal pain has to be differentiated from the following diseases: intussusception, ileal intestinal tuberculosis, intestinal typhoid, Crohn’s disease, etc. In conclusion, both doctors and patients must not only think of appendicitis when right lower abdominal pain occurs, but should actively consult a regular hospital if the diagnosis is not clear. For example, hemorrhage caused by ectopic pregnancy may be life-threatening if treated conservatively according to appendicitis.