Background: Complicated appendicitis is associated with a significant risk of postoperative morbidity, making the value of the laparoscopy as the first choice in the management of complicated appendicitis controversial. The objective was to study the safety and effectiveness of laparoscopy in the management of complicated appendicitis. Patients and methods: From June 2010 to September 2014, 82 consecutive patients who underwent laparoscopic appendectomy for complicated appendicitis in 2 private hospitals in Jeddah and Ain Shams University Hospital were evaluated in a retrospective way. Complicated appendicitis was defined as perforation with a purulent peritoneal collection, abscess formation, or generalized peritonitis. The outcomes, including operative time, conversion rate, mean hospital stay,and postoperative complications were chosen to evaluate the procedure. Conclusion: Our study demonstrated that management of complicated appendicitis laparoscopically is feasible, safe and can offer a low incidence of infectious complications, less post-operative pain, and rapid recovery.