Background: Althoughinflammatory disease of the vermiformappendix has been recognized as such for morethan 100 years, its etiology remains asubject of controversy.The notionthat appendicitisisfamilial, is not only important for understandingthe etiology of the condition but might contribute substantially to the diagnosis and thus provide an indication for early surgical intervention.Methods: An extensiveMedline search, textbooks, scientific reportsand scientific journals are the data sources.Conclusions: In the light of past studies, we can suggest that almost half of the variability in risk of acute appendicitis is due to genetic factors. Ap ositive family history increases the relative risk of beingacute appendicitisnearly 3times.