Purpose: Aim is to study the relationship between hyperbilirubinemia and elevated liver enzymes and acute appendicitis and to evaluate its credibility as a diagnostic marker for acute appendicitis.

Materials and methods: This is a prospective study conducted at the Chengalpattu Medical College Hospital, Chengalpattu, Tamilnadu, India between september 2017 to january 2018 were studied  on 100 consecutive cases of acute appendicitis admitted to the emergency ward. These cases were also subjected to liver function tests and clinical diagnosis was confirmed perioperatively and post–operatively by histopathological examination.

Results:As in perforated acute appendicitis there is altered liver function like evidenced by elevated liver enzymes and hyperbillirubinemia.

Conclusion: Finding of the present study suggest Serum bilirubin levels and liver enzyme appears to be a promising new laboratory marker for diagnosing acute appendicitis with perforation.