ABSTRACTBackground: Appendectomy for presumed acute appendicitis is the most common surgical emergency during pregnancy, acute appendicitis occurs at the same rate in pregnant and non pregnant women, but pregnant women have a higher rate of perforation. Patients &methods: This prospective study done 42 pregnant women between age 20 to 41 years all of them were complained from signs and symptoms of acute appendicitis arrived ER of Al Hussain teaching hospital in AL Nassyria during period 2010 either came directly or referred from gynecologist ,they underwent appendectomy early after diagnosis .Results: Most of patients succeeded pregnancy 38 patients (90.4%) { in spite of 3 patient (7%) have threatened abortion anther 3 patients have preterm uterine contraction but they continue of pregnancy successively},only 4 patient (9.5%) end with abortion.Most of women [21patients (50%)] complained from acute appendicitis during second trimester .Most of patients who did not delay operation till 48 hours can pass pregnancy successfly with some problems , while who delayed more liable to abortion [4 of 10 patient (40%)] . Aim: reduce fetal loss after appendectomy during pregnancy. Conclusion: we advices early operation in pregnancy with out delay, no place for conservative management in acute appendicitis .