Abdominal pain is a common clinical symptom in pediatric patients and is often prone to misdiagnosis or underdiagnosis. The main clinical manifestation of pediatric appendicitis is abdominal pain, but its characteristics are different from those of adults, as children do not articulate pain well, especially children younger than 3 years of age who usually just cry. Children are also uncooperative on physical examination, and pediatric appendicitis needs to be differentiated from a variety of conditions that present with abdominal pain, and without experience in examining children, especially infants, it is sometimes difficult to make a correct diagnosis. The typical abdominal pain in pediatric appendicitis is metastatic right lower abdominal pain, that is, early manifestation of upper abdominal pain, and as the disease progresses the abdominal pain shifts to the right lower abdomen, followed by constant, fixed pain in the right lower abdomen. It is often accompanied by gastrointestinal symptoms such as nausea and vomiting, and fever begins to appear. Physician examination may reveal fixed pressure points in the right lower abdomen, and in severe cases there is abdominal muscle tension and even rebound pain. Laboratory tests with elevated blood leukocytes and ultrasound examination are also helpful in the diagnosis of appendicitis. The typical pediatric appendicitis is not difficult for a specialist to diagnose. In general, once diagnosed, pediatric appendicitis should be treated surgically as soon as possible if there are no other serious illnesses affecting the life of the child, such as leukemia. Appendicitis is pathologically divided into simple appendicitis, suppurative appendicitis, gangrenous appendicitis, and perforated appendix. In the early stage, simple appendicitis, the inflammation is limited to the superficial appendiceal tissue and can be cured quickly with surgical treatment. However, once the appendicitis has progressed to perforation or the formation of a large abscess, the treatment is often significantly more difficult, mainly because of the relative difficulty of surgical removal of the appendix, the increased chance of complications after surgery, the significantly longer treatment time, and the exponential increase in treatment costs. Recently, we have found that many children operated for appendicitis have developed appendiceal perforation or even appendiceal abscess, which brings great problems to the treatment and recovery of the children, and some even have serious complications, such as intestinal obstruction, abdominal abscess and incisional infection. In fact, many of these children were correctly diagnosed at an early stage, but many parents did not choose the correct treatment – surgery – and instead took the initiative to adopt conservative treatment, thus delaying the timing of treatment. Parents may choose conservative treatment because of the following considerations: first, they are afraid that the long hospital stay for surgery will delay their children’s studies; second, they are afraid that the surgery will bring pain to their children; third, they think that appendicitis is a simple disease that can be cured with a shot. The conservative treatment of appendicitis has a set of strict measures, including active anti-inflammatory treatment, food prohibition, and active nutritional support treatment, and strict observation of changes in abdominal pain, and once the abdominal pain worsens and expands, surgery may be required immediately. Of course, it is true that some children are indeed misdiagnosed after consultation. Laparoscopic appendectomy is now more widely used. Laparoscopic surgery only requires 2-3 small 3mm-5mm holes in the abdomen, which is less traumatic and results in quick recovery. Simple appendicitis can be discharged 2-3 days after surgery, and there is no obvious scar on the abdomen after surgery. If your child develops abdominal pain, it is best to see a specialist at a specialized hospital. Once appendicitis is diagnosed, the best treatment is early surgery.