Background: The role of parasitic infections in acute appendicitis is still debatable. We aimed to investigate the role of parasitic infections in acute appendicitis as a neglected risk factor in an attempt to early recognition and treatment. Patients and Methods: A retrospective study included 1365 patients who underwent appendectomy. Demographic data, presentation, complications, investigation, and pathological reports were obtained from patients' records. Patients were categorized into two groups: group I (n=37), with parasitic infections present, and group II (n=1328) absent parasitic infections. Results: The prevalence of acute parasitic appendicitis was 2.7%. The mean age group of patients with appendiceal parasitic infections was 23.86±10.1 years with a male/female ratio of 1.6:1.  The detected parasites were 21 (56.8%) Enterobius vermicularis, 9 (24.3%) Ascaris lumbricoides, 7 (18.9%) Schistosoma mansoni. The histopathological examination of acute appendicitis with parasitic infections revealed non-complicated histopathology in 62.2% of specimens, acute catarrhal inflammation in 13.5% of specimens, acute suppurative appendicitis in 16.2%, acutely gangrenous appendicitis in 5.4% of specimens and with schistosomiasis infection there was acutely gangrenous appendicitis with perforation in 2.7% of specimens. Common presenting symptoms in acute appendicitis with parasitic infections were nausea in 86.5%, and periumbilical pain in 78.3%. The complications were significantly common among acute appendicitis patients with parasitic infections (13.5%) compared to those without parasitic infections (4.1%) (p=0.006). There is no reported mortality among studied cases.  Conclusions: The current study demonstrated that acute parasitic infection is one of the infectious agents that may increase the risk of appendicitis and can be identified postoperatively in the resected appendix. These findings emphasize the importance of considering the neglected role of parasites in acute appendicitis. As a result, early detection and treatment of parasites are recommended for complete eradication.