Appendicitis is one of the most common surgical emergencies, and surgical intervention remains the gold standard for curative treatment. Although laparoscopic appendectomy is associated with less pain, shorter hospital stays, and earlier mobilization, it is also more frequently complicated by postoperative abscesses. Retained appendicoliths are a rare complication that can serve as a nidus for repeated infections. Laparoscopic removal of the stone can provide definitive source control and reduce repeated hospital admissions. There are many surgical approaches for retrieval and this case, in particular, describes a laparoscopic hand-assisted approach while simultaneously using an interventional radiologic drain to assist with localization.