As noted in the introduction to this chapter, the unbridled enthusiasm for laparoscopic appendectomy was somewhat reigned in by the realization that in boys, adolescents, and even grown men, the treatment of appendicitis, strongly suspected clinically and confirmed by sonography, is served just as well by an old fashioned McBurney incision as by the elaborate doings of laparoscopy. However, the slightest concern with a differential diagnosis, such as ruptured duodenal ulcer, Meckel’s diverticulitis, or adnexal disease in women, does return laparoscopy to its full importance, both as a diagnostic and therapeutic measure.