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The purpose of the present study was to determine the prognostic factors in predicting recurrence of acute appendicitis after conservative therapy. Materials and method : Since August 2002 to June 2006, 353 patients were admitted to our hospital for acute appendicitis. In these cases, 218 patients underwent operation during admission, and we followed up remaining 135 patients who underwent conservative therapy. Recurrent patients regarding age, gender, laboratory data, and CT findings at their initial admission were compared with non-recurrent patients. Results : Recurrent right lower quadrant pain developed 33 of 101 patients (32.7%), who were able to be followed up more than 12 months after discharge. 30 patients were diagnosed as relapsing acute appendicitis by our hospital or other medical institutions, and 18 of 30 patients (60%) underwent operation. There was no significant difference in gender, body temperature, or CRP between recurrent and non-recurrent patients. Mean age of recurrent patients versus non-recurrent patients was 16.0 versus 30.0 (p<0.001), and mean white blood cell level was 13300 versus 11600 (p<0.05) at the onset of appendicitis. Ascites, inflammation around the appendix, and enlarged diameter of appendix (over 9.0 mm in diameter determined by CT scan) at the onset of the appendicitis increased risk of recurrence, but not having fecal stone in the appendix. Conclusion : Acute appendicitis recurred in over 30 % of the patients undergoing conservative therapy at initial admission and 60 % of relapsing patients underwent operation. We would deliberately select conservative therapy against patients suffering acute appendicitis in the young, having high white blood cell levels, and showing inflammatory signs based on CT findings.