Background Acute appendicitis is the most common cause of emergency abdominal surgery. This study aimed to describe the characteristics of acute appendicitis and investigate the outcome of open appendectomies at Lautoka Aspen Hospital. Method A retrospective cross-sectional study including all patients who had undergone open appendectomy with the diagnosis of acute appendicitis from 1st September 2022 till 1st September 2023 at Lautoka Hospital. Results A total of 217 patients were included in this study. The majority of the patients were in the age range of 11 – 30 years of age (50.5%) with male predominance (56%). The majority of patients were from Lautoka city (38%). The mean duration of symptoms was more than 2 days. The most common presenting symptom was localized right quadrant pain (59%), while right lower quadrant direct tenderness was the most common sign (94%). Leukocytosis was seen in 75% of the patients. Abdominal ultrasound was done for the majority of the patients (92%) with a sensitivity and specificity of 81% and 33.3% respectively. The most common intraoperative finding was complicated appendicitis (60%) with a mean duration of hospitalization of 4.61 days. The complication rate of this study was 23.5% with surgical site infection being the most common (19%). The negative appendectomy rate of this study was 7% with a mortality rate of 0%. Conclusion Acute appendicitis remains one of the most common surgical emergencies world wide . While the management of acute appendicitis continue to evolve, ensuring timely intervention and addressing barriers to care remain essential in improving patient outcomes and reducing the burden of this condition on health care system. Further research is needed to initiate the shift towards minimally invasive operative management and outline strategies to reduce disparities in health care services.