During the last decade, a laparoscopic approach for a suspicion of appendicitis has become more common in surgical practice. In case the appendix looks normal the guideline of the Dutch Society of Surgeons advices not to remove it. [1] The morbidity of a negative appendectomy is approximately 6% and it also leads to additional costs. [2] However, until recently no criteria on how to assess the appendix during a laparoscopy has been published. In a recently performed pilot study the investigators defined the Laparoscopic APPendectomy (LAPP) score. [3] The LAPP score is an easy applicable score that can be used during a diagnostic laparoscopy to evaluate the appendix on the presence or absence of 5 laparoscopic criteria on appendicitis. In our prospective cohort, use of the LAPP score would have led to a positive predictive value of 99% and a negative predictive value of 100%.