Background: Appendectomy is a widespread emergency surgery, and to date the appendectomy is still done through two approaches: open (OA) and laparoscopic (LA) and it is not known which is better than the other. Objective: This study aimed to compare OA and LA surgical approaches in patients with acute appendicitis. Patients and methods: Data were obtained from eighty patients underwent appendectomy at Baquba Teaching Hospital between September 2021 and May 2022. Forty patients in (OA) group underwent open surgery, as well as forty other patients in (LA) group underwent laparoscopic surgeries. The two groups were compared according to the operation time, hospital stay, wound infection, and return to normal daily activity. Results: LA approach was associated with shorter (1.4±0.6 days) hospitalization than OA (2.7±2.5 days). Also, the operative time of the laparoscopic approach was clearly less (30±3.2 min) compared to the open approach (35±5.2 min). There was no postoperative infection in the LA patients, and the laparoscopic patients returned to their daily activities faster than the open surgery group. Conclusion: Laparoscopic surgery is a safer approach to appendectomy, especially if it is performed by skilled specialist surgeons.