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The purpose of this study is to evaluate the outcome of laparoscopic (LA) vs. open appendectom y (OA) in children under 12 years old w ith perforated appendicitis. Methods: W e reviewed the m edical files of 156 children who underwent LA (n=96), OA (n=59), and conversion (CO) (n=1), and com pared duration of operation, length of hospital stay, incidence of w ound infection, m echanical ileus, intra-abdom inal abscess (IAA), and re-adm ission. Results: Com pared to O A, LA resulted in longer duration of operation (58.32± 17.105 m in vs. 44.27± 18.735 m in; p= 0.001), but few er w ound infections (2.1% vs. 10.2% ; p= 0.054), and few er cases of m echanical ileus (0% vs. 5.1% ; p=0.053). No differences in the length of hospital stay (5.85± 1.824 days vs. 6.10± 3.027 days; p= 0.526), IAA (2.1% vs. 1.7% ; p= 1.000), or re-adm issions (2.1% vs. 5.1% ; p=0.369) w ere observed. Conclusion: W e report that although LA showed an association w ith longer duration of operation com pared to O A, it is superior to O A w ith regard to incidence of w ound infection and m echanical ileus.