Background: Perforated appendicitis is one of the common surgical emergencies which need immediate surgical intervention.For many years, the classic open appendectomy still seems to be the routine treatment of perforated appendicitis. The improvement of technology and an increase in laparoscopic experience have been central to the development of laparoscopic surgery.The aim of this study is to compare outcome of laparoscopic versus open surgery for surgical management of perforated appendicitis in our locality. Patients and Methods: This is a prospective study that included 40 patients with perforated appendicitis admitted at general surgery department in Qena university hospital “between April 2018 to April 2019", 20 patients underwent open appendectomy and 20 had laparoscopic surgery. All patients subjected to: full clinical evaluation, diagnostic modalities as: laboratory investigation, plain X-ray erect and abdominal sonography. Results:All cases were completed successfully.A20 patient underwent open conventional surgery their mean age 29.80±7.32 years. While those underwent laparoscopic surgery were 20 patients and their mean of age 28.80±7.37 years. There were statistically significant differences between studied groups regarding operative time,time to return to a normal diet, length of hospital stayand postoperative complications. Conclusion: Laparoscopicsurgery for perforated appendicitisis safe and carries many advantages of minimallyinvasivetechniques. So, it should beused selectively, reservingthe traditionalopen approach.