Acute appendicitis is one of the predominant causes of emergency abdominal surgery, delay or misdiagnosis of AA can increase the risk of perforation. White blood cell count (WBC), absolute neutrophil count (ANC), and C-reactive protein (CRP) test are widely used in diagnosis, but their extrapolative exactness vestiges restricted. The Neutrophil / Lymphocyte Ratio (N/L ratio) may offer a more wide-ranging appraisal by revealing both inflammatory and severity condition. Aim of Study: To evaluate the usefulness of NLR in the differentiation between uncomplicated and complicated acute appendicitis. Methods: The investigation comprised 105 sufferers who performed appendectomy between January 2022 and December2023. Based on surgical and pathological findings, participants were pigeonholed into two groups: complicated and uncomplicated appendicitis. Sociodemographic data, combined with lymphocyte, WBC, CRP, and N/L ratio values, were documented. The diagnostic performance of these parameters was statistically inspection. Results: Among the 105 participants, 50 (47.6%) were identified as having severe appendicitis. Complicated group exhibited a significantly higher mean of age CRP, WBC, ANC, and N/L ratio than uncomplicated acute appendicitis. The cut-off value for NLR to differentiate between complicated acute appendicitis and uncomplicated acute appendicitis was taken as 8.6, with a sensitivity of 84 % and specificity of 85%. Conclusion: The boundary value of NLR is 8.6 may provide more helpful information for prophesying the severity of appendicitis, therefore NLR can be used to discriminate between complicated and uncomplicated appendicitis and help to diminish the negative appendectomy incidence.