Based on recent reports from the field of digestive surgery, laparoscopic surgery has made rapid progress. However laparoscopic appendectomy (LA) has not been a common procedure. We investigated the current state of the treatment of acute appendicitis in a suburban municipal hospital. Appendectomies performed in Sanda city hospital from April 2009 to March 2011 were evaluated. Thirty four cases (male: female 23: 11) were treated with laparoscopic appendectomy, 43 cases (male: female 37: 6) with open appendectomy (OA). The operation time of LA was significantly longer than that of OA (LA 81.8±28.5minutes and OA 65.8±22.8minutes). Most of the LA procedures were performed in the daytime whereas OA tended to be performed during the night or on holidays. The hospital stay in LA was 6.4±2.6 days, and 7.5±5.8 days in OA. The frequency of surgical site infection (SSI) of LA was lower than that of OA. On review of our 77 patients, we conclude that the laparoscopic approach is useful for treatment of acute appendicitis and will develop in many hospitals.