Acute appendicitis is the commonest non obstetric surgical emergency during pregnancy , but an accurate diagnosis is still an enigma .Appendicitis also occurs in nonpregnant females.The classical features of acute appendicitis are found in nonpregnant patients which lack in pregnant patients. The position of appendix changes due to enlargement of uterus as the pregnancy advances in different trimesters. Anatomical shifting of the appendix by the enlarging uterus makes the clinical and sonographic diagnosis difficult. Prompt diagnosis and treatment are essential to prevent perforation, which increases the risk of fetal and maternal death. Surgical intervention, either by an open laparotomy or laparoscopy is the most appropriate treatment for appendicitis. AIM: To review epidemiology, clinical diagnosis, investigation, complications and treatment of acute appendicitis in pregnancy