Acute appendicitis is present in one in 500 to 2000 pregnancies (which amounts to 25% of operative indications for the acute abdomen in pregnancy). Pain in the right lower quadrant is the most reliable symptom and after the third month of pregnancy, the pain moves progressively upwards and laterally. Abdominal tenderness is almost always present and rebound tenderness in 55% to 75% patients. Abdominal ultrasound is the diagnostic procedure of choice with less accuracy in the third trimester with no guidelines about the use of transvaginal ultrasound. Magnetic resonance imaging (MRI) is the diagnostic modality of choice in patients for whom the risks of radiation or the potential nephrotoxicity of iodinated contrast agents is a major concern. This book examines the occurrence, symptoms and severity of acute appendicitis in pregnancy.