Little research is found in the nursing literature regarding appendicitis in the pregnant patient. Appendicitis in pregnancy is associated with: perforation of the appendix, peritonitis, and increased fetal and maternal mortality and morbidity. Preterm labor and early delivery may further complicate the pregnancy. Advanced practice nurses may encounter pregnant women with abdominal pain who present in the primary care setting as well as in an obstetric office. Knowledge of signs and symptoms of appendicitis in pregnancy, potential complications, and outcomes is essential to nursing. Early recognition may decrease complications and improve outcomes. A 10-year chart review was performed at a large urban Midwestern hospital with a large obstetric department. Deliveries numbered more than 66,000 during the 10 years. A total of 42 cases of appendicitis during pregnancy and the 2 weeks following delivery was identified. The characteristics of the population as well as considerations for practice are discussed.