The clinical presentation of 105 cases of retrocecal appendicitis was reviewed. Thirty-six percent of the patients had the classic appendicitis scenario of periumbilical pain localizing to the right lower quadrant, accompanied by anorexia, nausea and vomiting, and tenderness and guarding in the right lower quadrant. The remaining 64 percent had subtle variations of this presentation. Retrocecal appendicitis did not have a distinctive clinical pattern in our series. Twelve of the 105 retrocecal appendices were also retroperitoneal. The diagnosis was delayed in four patients and two had flank pain. Five of the twelve appendices were either gangrenous or perforated. Although the number of patients is small, we conclude that the traditional type of retrocecal appendicitis can occur in the retroperitoneal subgroup but that his anatomic variation is infrequent. The incidence in our series was 2.5 percent.