Background: Acute appendicitis is one of the commonest general surgical problems seen in pregnant females. Prompt evaluation and management is of utmost importance to avert maternal and fetal morbidity and mortality. The aims and objectives of this study were to study the presentation and management of acute appendicitis in pregnancy. Methods: This was a prospective cohort study of 50 pregnant patients presenting with acute appendicitis over a period of 4 years in a tertiary care hospital of a developing area.Results: The mean age of the patients was 29.31 ± 4.83 years with most of them being in the age group of 25 - 30 years. Thirty-one (62%) patients hailed from the rural areas. Twenty-eight (56%) patients were primigravida. Majority of patients presented in the 2ndtrimester [28 (56%) patients]. Ultrasonography was used as the diagnostic modality of choice in 48 (96%) patients. Majority of the patients [47(94%)] were managed conservatively on intravenous antibiotics, analgesics and fluids. The mean hospital stay was 4.26 ± 1.29 days. Simple open appendectomy was needed in two (4%) patients whereas one (2%) patient required laparotomy because of generalized peritonitis. No maternal or fetal loss was seen in our study.Conclusion:Acute appendicitis is a common surgical emergency encountered in the pregnant females and usually responds well to conservative therapy. However early surgical intervention is warranted in case of peritonitis to circumvent maternal and fetal complications.