Introduction: Appendectomy is one of the most commonly performed emergency surgeries. As there is no consensus on the most appropriate technique, both open (OA) and laparoscopic (LA) methods have been used in appendectomy. This retrospective study aims to compare OA and LA in the treatment of acute appendicitis with regard totheir effectiveness and cost analysis.Methods: Data obtained from the records of patients who underwent appendectomy due to a diagnosis of acuteappendicitis were retrospectively evaluated. The patients were divided into two groups as LA and OA. The twogroups were compared with regard to age, gender, operative times, postoperative pain, complication rates, hospitalization times, return to daily activities, and cost.Results: At our hospital, 4474 patients (2765 M, 1709 F) underwent appendectomy due to a diagnosis of acuteappendicitis between September 2010-June 2017. Median age was 29.7 years (1-90 y). Of the patients, 806 underwent LA and 3668 OA. Median operative times were 43 min for the LA group and 39 min for the OA group (p>0.05).As the post-operative complication, wound infection was detected in 102 patients in the AA group and in 21 casesin the LA group (p>0.05). The total treatment cost was 37 USD higher for the LA group (p<0.05).Conclusion: Laparoscopic appendectomy is more advantageous than open appendectomy in terms of lesser needfor postoperative analgesia and faster return to normal life. At the time being, the only disadvantage of laparoscopic appendectomy appears to be its cost.