Aims and objectives: Acute appendicitis is the most common surgical disease with a lifetime risk of 7-8%. Numerous studies have shown many benefits of laparoscopic appendectomy over open appendectomies, such as better visualization and identification of other abdominal pathologies that can mimic acute appendicitis. Herein, we illustrated the current incidence of non-appendicitis pathologies during laparoscopic appendectomies in our hospital. Materials and methods: A retrospective study was carried out involving patients operated for acute appendicitis laparoscopically at the Surgical Emergency Unit, Zagazig University Hospitals, Egypt, during the period from March 2017 to December 2019. The diagnosis of acute appendicitis was based on clinical examination, laboratory findings, and ultrasonography. We drew out the patients' demographic data, duration of surgery, and surgical procedure reports. Results: One hundred forty-five patients presented clinically, and confirmed by laboratory and ultrasonography with the diagnosis of acute appendicitis. Eighty-nine were males, 56 were females. The median operative time was 56.5 minutes. Eight cases (5.5%) showed a pathology other than acute appendicitis, including gynecological pathologies, Mickel's diverticulitis, inflamed sigmoid appendices epiploica, low-grade appendiceal mucinous neoplasm, and inflamed cecal diverticulum. Conclusion: Diagnosis of acute appendicitis is challenging up to date. We faced many conditions mimicking acute appendicitis during surgical intervention.