Objective:To compare complication rates among patients managed conservatively versus those treated surgically for acute appendicitis (AA) during the initial wave of COVID-19. Materials & Methods:A total of 40 patients were enrolled and were randomized into two study groups; Surgical group and conservative group. Diagnosis of AA was made on clinical grounds. Failure of antibiotic treatment in the conservative group was defined as: appendectomy in the follow-up; recurrence of right iliac fossa (RIF) pain; re-admission with RIF pain. Post-operative complications in the surgical group were classified as procedure-specific complications and general complications.Criteria for safe discharge used were as follows: pain improving and manageable in the community. All the results were recorded in Microsoft excel sheet and was subjected to statistical analysis using SPSS software. Results:Mean hospital stay was similar in surgical group and conservative group (2.9 days Vs 3.1 days).Complications rate was similar in surgical group and conservative group (30% Vs 35%).Recurrence was similar in surgical group and conservative group (10% Vs 15%). Conclusion:Conservative management of AA can be both safe and effective. The efficacy of this classification process will be assessed by analysis once it is implemented.