Background: Acute appendicitis is the most common surgical cause of abdominal pain in adults and children. Endogenous inflammation is caused by obstruction of the lumen of the appendix with feces or a foreign body and is a frequent surgical emergency. The COVID-19 pandemic has strongly affected every aspect of human life, including surgical services and surgery. Aim: To determine the impact of the COVID-19 pandemic on the incidence of acute appendicitis in 2019 before the pandemic and in 2020 during the pandemic. Methods: The research includes data on the preoperative assessment of patients with abdominal pain admitted through the Emergency Department (ED) to the Department of Surgery of the Zadar General Hospital in one month of 2019 and the same period of 2020. Each patient was admitted to the ED through a triage procedure depending on the referring working medical diagnosis and the estimated degree of urgency. Demographic data, pre-operative data, intraoperative surgical findings and follow-up, histopathology report, and COVID status were collected for 131 patients. However, a total of 67 patients with acute appendicitis were included in the further analysis. Results: In our research, we set seven hypotheses. The number of patients with abdominal pain, the frequency of acute inflammation of the appendix, the advanced stage of inflammation upon arrival at the Emergency Department, the frequency of complicated appendicitis, the time since the onset of symptoms, and the length of stay after surgery was not significantly different in the given time period. According to the obtained results, we rejected the mentioned six hypotheses because there were no significant differences between the one-month period in 2019 and the same month in 2020. The hypothesis that patients in 2020 had more complications compared to 2019 was confirmed, although the sample of patients is too small and we can take this as a weakness of our research. Conclusion: According to the results of our research, the number of patients with appendicitis was equal in 2019 and 2020, from which we conclude that the pandemic does not promote or suppress the occurrence of appendicitis, and that such a condition in itself requires urgent care, regardless of a pandemic.