Background: Acute appendicitis is one of the most common surgical emergencies. Complicated acute appendicitis, which includes perforated and gangrenous appendicitis, poses significant treatment challenges. Laparoscopic appendectomy has emerged as a minimally invasive alternative to open surgery. This study evaluates the outcomes of laparoscopic appendectomy for complicated acute appendicitis at Patna Medical College & Hospital. Materials and Methods: A retrospective analysis was conducted on patients diagnosed with complicated acute appendicitis who underwent laparoscopic appendectomy. Inclusion criteria included patients with confirmed perforated or gangrenous appendicitis. Exclusion criteria included patients with simple acute appendicitis or those converted to open surgery. Data collected included demographic details, operative time, length of hospital stay, postoperative complications, and recovery time. Statistical analysis was performed using SPSS version 25.0. Results: A total of 150 patients met the inclusion criteria. The average age was 35 years, with a male-to-female ratio of 1.5:1. The mean operative time was 75 minutes (range 45-120 minutes). The average length of hospital stay was 5 days (range 3-10 days). Postoperative complications occurred in 20 patients (13.3%), including surgical site infections (8%), intra-abdominal abscess (3%), and prolonged ileus (2.3%). No mortalities were recorded. The mean recovery time to normal activities was 14 days (range 10-21 days). Conclusion: Laparoscopic appendectomy is a safe and effective treatment for complicated acute appendicitis. It is associated with a shorter hospital stay, low postoperative complications, and a quick recovery time. These findings support the use of laparoscopic appendectomy as the preferred surgical approach for complicated acute appendicitis at Patna Medical College & Hospital.