Abstract Introduction: Periappendicitis is defined as appendiceal serosal inflammation without mucosal involvement. It is a rare benign pathology, diagnosis is difficult and carries high morbidity. A detailed literature and large series are still lacking on periappendicitis. Aim of this study is to present our clinical experience with periappendicitis. Methods: 36 of retrospectively reviewed 1232 acute appendicitis patients were found to have periappendicitis on histopathological examination. Histopathological finding of appendicitis with periappendicitis in emergency appendectomy, and cases of interval appendectomy were excluded. Descriptive statistics were used to summarize the data. Results: The most common diagnosis was salpingitis (12), followed by pelvic inflammatory disease (9), typhoid enteritis (5), peritoneal tuberculosis (3), inflammatory bowel disease (3), and amoebiasis (1), while 3 cases remained undiagnosed. Discussion: Periappendicitis is due to extra-appendicular pathologies resulting in serosal inflammation of the appendix without mucosal involvement. In the absence of any significant history, it is difficult to distinguish periappendicitis from the common entity of acute appendicitis only on the basis of clinical examination and laboratory parameters. Conclusion: Pre-operatively, it is difficult to diagnose periappendicitis, but it should be considered if the clinical signs and imaging findings are suggestive of any associated pathology in addition to the presence of typical picture of acute appendicitis and post-operatively if the patient develops any new clinical signs, as this can cause morbidity to a significant level.