Acute appendicitis remains one of the most frequent emergencies in abdominal surgery. Surgery is usually straightforward and prognosis excellent. However, outcome depends essentially on how soon diagnosis is made. In Niger, the 1990s were marked by the development of private medicine and the deterioration of services in state health structures (health centres and hospitals). The goal of this prospective study, carried out over 24 months (March 1997-March 1999) was to analyse existing appendicitis prognosis in our country. The study population was made up of 362 patients and we based our survey on a number of factors found in the medical literature, and in particular on a similar study conducted in the same hospital in 1989 by another group of surgeons. Delays in diagnosis and thus therapy still today tends to transform prognosis for simple acute appendicitis into that of peritonitis. The numerous and varied post-operative complications keep the mortality rate at 4%.