Chronic appendicitis, after the diagnosis is clear, requires elective surgical treatment. If not surgically treated, it is prone to recurrent disease, affecting the quality of life and even normal life and work. Most chronic appendicitis is transformed from acute appendicitis, by a few begin with a chronic process. Chronic appendicitis has the potential to cause pain in the lower right abdomen frequently, with some patients experiencing only vague pain or discomfort. Strenuous activity or a poor diet can precipitate an acute attack, and some patients have a history of recurrent acute attacks. Physical examination will show localized pressure pain, and the location is relatively fixed. On physical examination in the left lateral position, a few patients will find a striated mass in the left lower abdomen. Definitive chronic appendicitis requires elective surgical removal of the appendix and pathologic examination to confirm the diagnosis. Inflammatory episodes can be treated with intravenous antibiotics such as ceftriaxone sodium and levofloxacin.