Background: Appendicitis is one of the most common surgical emergencies worldwide, requiring timely interventions to prevent complications such as perforation, peritonitis, and sepsis. The study aimed to compare the outcomes of open appendectomy (OA), conventional laparoscopic appendectomy (CLA), and single-port laparoscopic appendectomy (SPLA) in patients with acute appendicitis in terms of operative time, intraoperative blood loss, postoperative pain, complications, length of hospital stay, and recovery time.Materials and Methods: A prospective randomized controlled trial was conducted with 150 patients diagnosed with acute appendicitis. Patients were randomly assigned into three groups: OA (n=50), CLA (n=50), and SPLA (n=50). The primary outcome was postoperative pain assessed using the Visual Analog Scale (VAS) at 6, 12, and 24 hours. Secondary outcomes included operative time, intraoperative blood loss, length of hospital stay, postoperative complications, and return to normal activities. Statistical analysis was performed using ANOVA and the Chi-square test, with p<0.05 considered significant.Results: The mean operative time was significantly shorter in the CLA group (38.5 ± 4.8 min) compared to OA (45.3 ± 5.1 min) and SPLA (42.7 ± 5.3 min) (p<0.001). Intraoperative blood loss was highest in the OA group (75.2 ± 15.4 mL) and lowest in CLA (50.6 ± 12.7 mL) (p<0.001). Postoperative pain scores at 6 hours were highest in OA (6.8 ± 1.2) and lowest in CLA (5.4 ± 1.0) (p<0.001). The CLA group had the shortest hospital stay (2.1 ± 0.6 days) compared to OA (3.2 ± 0.8 days) (p<0.001). Surgical site infections were most common in OA (20%) and least common in SPLA (10%) (p=0.04). Time to return to normal activities was shortest in CLA (7.8 ± 1.2 days) compared to OA (10.5 ± 1.6 days) (p<0.001).Conclusion: CLA demonstrated superior outcomes compared to OA and SPLA in terms of reduced operative time, blood loss, pain, complications, and faster recovery. While SPLA showed advantages over OA, CLA remains the preferred approach for appendectomy due to its overall efficiency and patient benefits.