1.1. A review of 51 cases in which a clinical diagnosis of acute appendicitis was made during pregnancy or the early puerperium with one maternal death and two fetal deaths is reported. The signs, symptoms, and physical findings were discussed.2.2. The obstetrician must always be alert to the signs and symptoms of acute appendicitis in pregnancy and when in doubt it is best to operate no matter what the duration of the pregnancy.3.3. Laparotrachelotomy at the time of removal of an appendix, with but very few exceptions, is violation of good surgical procedure, and should not be performed.4.4. It is an acknowledged principle that elective appendectomy at the time of cesarean section or removal of an ectopic pregnancy increases the hazard of appendectomy.