Acute appendicitis in the elderly poses a challenge to the surgeon. The condition is often diagnosed late or misdiagnosed. Therefore there is a high incidence of complicated appendicitis in the elderly and post-operative morbidity and mortality are consequently high. This is a retrospective study done in a private hospital in Nigeria. Medical records of elderly patients (60 years and above) who had appendectomy from March 2007 to February2011 were collected and reviewed. The biodata, presentation and surgical outcome were analyzed. Seventeen elderly patients had appendectomy (12.23% of all cases of appendectomy) during the study period. All presented with abdominal pain and tenderness. Fever was only present in 6 (35.29%) and Leucocytosis was present in 9 patients (52.94%). Diagnosis was confirmed with abdominal ultrasound in all patients. There were five complications in this series (29.41%) and no mortality. Appendicitis in the elderly requires a high index of suspicion for an early diagnosis. This will translate to early treatment with reduction in morbidity and mortality.