Updated recommendations for managing acute appendicitis focus on improving surgical outcomes and patient selection.

• Clinical risk scores and imaging enhance diagnostic accuracy, lowering negative appendectomy rates.
• Nonoperative treatment with antibiotics is safe for select patients with uncomplicated appendicitis.

Delay appendectomy for uncomplicated cases by up to 24 hours without raising adverse outcomes.

• Laparoscopic appendectomy remains the go-to surgical method, with limited short-course antibiotics recommended postoperatively for complicated cases.