Laparoscopic appendicectomy (LA) may be the treatment of choice for acute appendicitis. Our aim was to assess LA in Greek reality. Within a year, 135 patients with a mean age of 29.25 years (14 to 67) underwent an operation for "acute appendicitis." We analyzed the hospital stay, the morbidity, the cost, and the severity of the inflammation and compared the open appendicectomy [OA (78)] with the LA (57) approach. There were no differences in the appendicitis severity (P = 0.667), and similar complication rate (P = 0.414) and mean hospital stay were observed between the groups (LA = 3.18 vs. OA = 2.97, P = 0.664). In the way, medical procedures are priced in Greece; the mean net cost of LA was 1320.60 euros (1748.05 USD), whereas for OA, it was 237.8 euros (314.77 USD). The severity of appendicitis is not a limitation for LA. Because of an insufficient costing system in Greece, the best cost effectiveness is for young women and obese men.