PURPOSE: Laparoscopic appendectomy is a popular surgical treatment of choice for children with appendicitis. This study compared laparoscopic appendectomy (LA) with an open appendectomy (OA) in children with simple appendicitis (SA) and perforated appendicitis (PA) to confirm the safety and effectiveness of the laparoscopic procedure. METHODS: A retrospective medical record review was performed on 193 patients who underwent an appendectomy at our institution from January, 2008 to August, 2011. The demographic properties and postoperative factors including complications were assessed. RESULTS: Among 140 SA, there were 81 and 59 cases of OA and LA, respectively. In SA, the time to bowel movement in LA was shorter than OA (0.9 vs. 1.2 days, p=0.0005) and the number of times analgesics were used in LA were significantly lower than OA (1.8 vs. 2.5, p=0.027). Of 53 PA, 30 cases received OA whereas 23 cases underwent LA. In patients with PA, the LA group were older (124.0 vs. 98.8 months, p=0.027) with a longer operative time (93.5 vs. 68.2 minutes, p=0.02). On the other hand, the time to diet was faster in LA (1.8 vs. 3.2 days, p=0.02). In both SA and PA, there were no significant differences between OA and LA with respect to gender, hospital stay, drain insertion, duration of antibiotics usage, and complications. In SA, the LA group had fewer complications than the OA group with borderline significance. CONCLUSION: LA is a safe and effective way to treat SA and PA in children.