Laboratory risk indicator for necrotizing fasciitis (LRINEC) score has been used as a tool in assessing the risk of necrotizing fasciitis in cases of soft tissue infection. This study aims to determine the LRINEC score as a predictor of necrosis and perforation in cases of pediatric appendicitis in Haji Adam Malik Hospital Medan. The study was retrospective with patient data collection from January 2014 to December 2014. Patient data were collected including age, LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) Score, and postoperative histopathology. For 12 months, 30 patients with acute appendicitis who met the inclusion criteria obtained a strong correlation of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score with operating findings, Pearson correlation coefficient (r) of .551 and p–value 0.002 (0.002 <0.05, significance 0.05). With the LRINEC score cutoff ≥ 9 it has a positive predictive value of 78.5% (95% CI) and a negative predictive value of 62.5% (95% CI). The sensitivity itself is 64.7%, and the specificity is 76.9%. LRINEC score could be utilized in the management of preoperative and postoperative appendicitis patients in children