The present study investigates patients with acute appendicitis who presented to a hospital with no acute surgical service (group A) and compares the outcomes of these patients with those that presented to a tertiary centre with an acute surgical service within the same health network (group B). All group A patients were transferred to the group B hospital for appendicectomy. Methods: During a 10-month period, 257 patients (80 in group A, 177 in group B) with acute appendicitis were analysed retrospectively. Demographics, emergency department parameters, time to waiting bay, time to surgery, operative time, complications, length of stay and the stage of appendicitis were all noted for each group. A comparison of each of these parameters was made between the two groups of patients. Results: There were 80 patients in group A and 177 patients in group B. There was a significant difference between the two groups in the fields of length of stay in the emergency department (P= 0.003), bed availability (P= 0.038), time to waiting bay (P= 0.006) and time to surgery (P= 0.006). There was no significant difference in the total length of stay and complication rates between the two groups (P= 0.58 and 0.78, respectively). Conclusion: This study concludes that patients with acute appendicitis presenting to a hospital with no acute surgical services had a greater waiting period prior to surgery. However, this did not translate into greater complication rates or length of stay for these patients. We propose a prospective study to further analyse the outcomes in such patients.