A total of 701 patients operated on with the suspected diagnosis of acute appendicitis were included in a prospective study. Three hundred and nine patients were treated conventionally and 387 laparoscopically. In 14 patients the operation had to be converted. Operating time was 44 min in the laparoscopic group and 54 min in the conventional group. The advantages of the laparoscopic technique were better visualisation of the abdominal cavity, fewer complications, shorter hospital stay and better cosmetic result. Complications occurred in 2.9% of the patients in the laparoscopic group and in 13.6% of the patients in the conventional group. All complications following laparoscopic procedures could be treated laparoscopically.