Background: Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis. Appendectomy is the most common abdominal operation performed as an emergency basis. Objective: The aim of the study was to evaluate the management of acute appendicitis during different stages of pregnancy as regard the diagnosis, operation time, operative and post-operative complications and pregnancy outcome. Subjects and Methods: This prospective study included a total of 20 pregnant women who had signs and symptoms of acute appendicitis which admitted at Al-Azher University Hospitals and Elmenia General Hospital from March 2018 till November 2018. All patients were subjected to open appendectomy under spinal anesthesia. Results: Abdominal pain, nausea, vomiting, leucocyte count, CRP and body temperature were not helpful in establishing the correct diagnosis. There was no maternal morbidity related to the appendectomy. We found no increase in pregnancy complications in cases with appendicitis. Conclusion: Accurate and prompt diagnosis of acute appendicitis should be done to avoid un-necessary exploration and to aim for timely surgical intervention in pregnant women suspected of having appendicitis.