PURPOSE: This clinical study evaluated the feasibility of needlescopic appendectomy (NA) in young patients with acute appendicitis, and we compare the outcome of this new technique with that of conventional laparoscopic appendectomy (LA). METHODS: Two groups of young patients who underwent laparoscopic appendectomy at Sanggye Paik Hospital between January 2009 and December 2009 were studied. In the first group, a 2-mm instrument appendectomy was performed in 13 patients. These patients were compared with the second group, which were 21 patients who underwent conventional laparoscopic appendectomy. Statistical significance was set at p values<0.05. RESULTS: The patient demographics and operative findings were similar in both groups. There was no conversion to open appendectomy in either group. Postoperative ileus was occurred in 3 patients who underwent LA, but there was no statistical difference between the both groups (p=0.154). The needlescopic group had a shorter mean operative time (p=0.65), but there was no statistically significance. The mean hospital stay was significantly shorter (p=0.026) in the needlescopic group than that in the conventional laparoscopic group. CONCLUSION: According to our experience, needlescopic laparoscopic appendectomy is a safe and feasible procedure as compared with that of conventional laparoscopic appendectomy in young patients.