Background: Acute appendicitis still remains mystery. In spite of tools like ultrasonography, & CT the failure rate of diagnosing appendicular perforation in cases of appendicitis is high.Acute appendicitis is most frequently encountered emergency. Objectives:This study was done to find out whether appendicular perforation can be predicted by Serum Bilirubin level. Material Methods:166 patients diagnosed acute appendicitis or appendicular perforation were evaluated with LFT and Serum Bilirubin at D.Y.Patil hospital during 2016 to 2018 in an observational cross sectional study. Results:Of 166 patients ,137(82.53%)were with Non–perforation Appendicitis, 14.6%&85.4% had raised & normal bilirubin respectively, and of 29 with Appendicular Perforation 23(79.31%)&6(20.69%) had raised & normal bilirubin levels respectively. Sensitivity & Specificity of Serum Total bilirubin as Diagnostic marker in Non–perforated & Perforated appendicitis was 79%&85% respectively. Conclusion: Serum total Bilirubin(Hyperbilirubinemia) looks like a convincing laboratory marker for prediction of appendicular perforation