Abstract：Objective To analyze the effectiveness of abdominal CT in diagnosing acute appendicitis. Methods From January 2022 to January 2023, 60 patients with suspected acute appendicitis were selected and underwent abdominal CT scans at our hospital. Pathological examination was used as the gold standard, and analyzed the diagnostic effect of CT scans. Results There was no significant difference in accuracy, sensitivity, specificity, and detection efficacy for simple appendicitis, suppurative appendicitis, and gangrenous perforated appendicitis between CT and pathological examination （χ2＝3.077, 2.035, 1.333, 1.018, 0.000, 0.000, all P＞0.05）. The rate of exudation CT signs in suppurative appendicitis was higher than that in other types of appendicitis （χ2＝11.101, P＜0.05）. The diameter of the tube in perforated gangrenous appendicitis was greater than that in other types of appendicitis （t＝54.715, P＜0.05）. Conclusion Abdominal CT is effective in diagnosing and differentiating acute appendicitis.