Appendicitis is a rarely observed surgical pathology in neonates. Diagnosis is frequently delayed and it usually results in perforation. We presented a case of perforated appendicitis in order to attract attention to this high morbidity and mortality causing pathology.An 11-day old male patient was referred to our clinic with complaints of vomiting with bile content and abdominal distension. On physical examination, abdominal distension, diffuse abdominal sensitivity with palpation, and swelling and mild hyperemia on the right scrotum were observed. The patient was operated with a prediagnosis of intestinal obstruction. During operation, perforated appendix was observed and appendectomy was performed. The patient had no problems postoperatively except wound infection. The patient was followed especially for the occurrence of right inguinal hernia. Although appendicitis is one of the frequent pathologies of childhood, it is rarely observed in neonates. The diagnosis is almost always made operatively and the appendix is usually found as perforated. Therefore, it has high morbidity and mortality rates. In our case, the swelling around right testis, caused by the accumulation of abdominal purulent liquid from an open processus vaginalis, was added to clinical symptoms. As a result, the diagnosis of appendicitis should be kept in mind in neonates presenting with intestinal obstruction symptoms

Keywords: Perforated appendicitis, neonate, scrotal swelling