Introduction: Since the early 20th century, treatment of acute appendicitis has been primarily surgical as appendectomy. Several studies suggest appendectomy may not be necessary for patients with acute uncomplicated appendicitis, with treatment using antibiotics being sufficient. Patients and method: This is a Prospective randomized clinical trial done on adult patients presented to Kasr El-Aini Hospital emergency department with clinically suspected, uncomplicated appendicitis, to compare antibiotic treatment to surgical treatment in uncomplicated appendicitis, from May 2016 to August 2016. Results: A total of 150 patients satisfied our criteria and were included in the study. Of the 67 patients in the antibiotic group, 62 (92. 5%) did not require appendectomy within the follow up period of 3 months. Despite having recurrent appendicitis and delayed operations, only 2 patients of the 5 who eventually underwent appendectomy had postoperative surgical complications in the form of superficial surgical site infection. While in the surgical group, 32 patients (39%) had various postoperative complications ranging from surgical site infection to intra-abdominal abscess. No patient in the antibiotic group developed an intraabdominal abscess, including those who underwent delayed appendectomy. Conclusion: Antibiotic therapy is an effective form of treatment that can be offered to uncomplicated appendicitis patients in hospitals in Egypt. It has a high success rate, and a low rate of complications in case they required surgery later in the course of the disease. Further studies in the form of randomised controlled trial should be attempted with larger numbers of patients and longer periods of follow up. Key Words: Uncomplicated appendicitis, conservative treatment, surigcal treatment.