Augmentin as single agent was compared to the combination of metronidazole/gentamicin in the prevention of sepsis after appendicectomy. Two hundred patients admitted to Riyadh Central Hospital with a clinical diagnosis of acute appendicitis were enrolled in a prospective randomized study. All patients had a preoperative chest X ray, CBC, urinalysis and any other necessary investigations. Patients received either drug regime intravenously, 30 min prior to surgery. The overall incidence of wound infections in the Augmentin group was 8% as compared to 14 % in the metronidazole/gentamicin group. There were no intra-abdominal abscesses in either group. Patients with perforated or gangrenous appendices received a 3- to 5-day course of treatment. All the early wound infection (2–4 days after operation) occurred in patients with gangrenous or perforated appendices. The results were studied statistically using χ² and there was no statistically significant difference between the infection rates in the two treatment groups whatever the state of the appendix at operation. Augmentin is as effective and well-tolerated as metronidazole/gentamicin in the prevention of wound infection following appendicectomy. The ease of administration of one drug with added antian-aerobic property makes Augmentin superior to the tested combination.