Appendiceal abscess developed in 2% of 2,621 patients with acute appendicitis seen between 1962 and 1976. While representing a commendable decline in frequency from earlier studies, in view of the demonstrated prolonged delay in seeking medical care, further decreases in incidence could be affected by increased patient education. Sixty-one of 68 patients underwent surgical drainage of the abscess, with a 28% complication rate. Interval appendectomy was performed in 42 cases, with a 19% complication rate. Two patients (3%) died. These rates do no differ appreciably from those reported during the preantibiotic era. Recurrent appendicitis developed in only one of 13 patients not undergoing interval appendectomy during a follow-up period averaging five years. Interval appendectomy should be withheld only in those poor-risk patients in whom the 10% to 20% incidence of recurrent appendicitis seems the smaller risk.