Background: The most frequent emergency abdominal disease that necessitates surgery is acute appendicitis. The present study was conducted to compare open versus laparoscopic appendectomy in perforated appendicitis. Materials & Methods: The study was conducted at PMCH Patna, Bihar from August 2021 to August 2023.80patients withperforated appendicitiswere divided into 2 groups. Each group had 40 patients. Group I patients underwent laparoscopy appendectomy and group II patients underwent open appendectomy. Parameters such as operating time, hospital stay, complications were recorded. Results: Group I had 16 males and 14 females and group II had 13 males and 17 females. Symptoms were nausea/vomiting seen 29patients in group I and 31patients in group II, abdominal pain in 37patients in group I and 35patients in group II and fever in 36patients in group I and 32patients in group II. The mean operating time (minutes) was 45.2 in group I and 54.1 in group II, oral feed started postoperatively on 5.9 days and 2.6 days and hospital stay (days) was 4.6 and 3.7 in group I and II respectively. The difference was non- significant (P> 0.05). Complications were wound abscess seen in 2 in group I and 3 patients in group II and wound infection 3 in group I and 6 in group II. The difference was significant (P< 0.05). Conclusion: Compared to open appendectomy, laparoscopic appendectomy is a safer and more successful treatment for patients with acute appendicitis.