Introduction: The appendix though a vestigial organ in humans, appendectomy is one of the most commonly performed surgical procedures on emergency basis. Pathologic evaluation of these specimens may reveal unexpected findings occasionally. Aim: A retrospectively study was done to determine histological diagnosis of acute appendicitis and its complications, negative appendectomy rate and unusual histopathological findings. Materials and Methods: Histopathologicalrecords of 240 patients (Male: Female: - 152:88) who underwent appendectomy for acute appendicitis between April 2017 to March 2020 at a rural center in Puducherry. The patient’s age, sex, macroscopic and histopathological examination findings were noted. The specimens with unusual histopathological findings were re-evaluated in detail regarding patient’s demography and its clinicopathological implications. Results: Out of 240 casesthepeak age of incidence of appendicitis was between 16 to 30 years in both sexes. Histological data showed acute appendicitis in 228(95%)which includes acute phlegmonous148(65%), lymphoid hyperplasia 46(20%), gangrenous appendicitis 18(8%), perforated 9 (4%) and with unusual histopathological findings in 7 (3%). Negative appendectomy rate was 5%and it was seen in females between age group of 16 to 30 years. Conclusion: Our study shows higher number of appendicitis in young adults and negative appendectomy rate in females of reproductive age group. So we recommend all appendectomy specimens even having normal gross appearance should undergo routine histopathological examination to avoid any clinically important and treatable conditions. Keywords: Acute appendicitis; Histopathology; Appendectomy.