Objective To explore the clinical application value of laparoscopic appendectomy(LA) versus open appendectomy(OA) in the diagnosis and treatment of complex subhepatic appendicitis in children. Methods Forty cases of subhepatic appendicitis were retrospectively analyzed and divided into LA (22 cases) and OA (18 cases) groups according to the surgical approach. The time required for preoperative diagnosis, operation time, intraoperative blood loss, inflammatory parameters 24 hours after operation, postoperative exhaust time, wound infection, abdominal abscess, intestinal obstruction, hospitalization time and hospitalization cost were compared between the two groups. Results Among them, 19 children undertook laparoscopy while three converted into traditional open operation. Comparison between the two groups in terms of intraoperative bleeding, postoperative 24hCRP, postoperative exhaust time, and hospitalization cost showed statistically significant differences (P＜0.05); whereas there was no difference between the two groups in terms of operative time, postoperative complications, and hospitalization time (P＞0.05); Preoperative undiagnosed cases: 6/4 in LA group/OA group (P＞0.05), but clinically significant.Conclusion Laparoscopic surgery is a safe, feasible and effective minimally invasive method for the diagnosis and treatment of complicated subhepatic appendicitis in children. It has the advantages of less trauma, less bleeding, quick recovery, economic and practical, and is worthy of being popularized and applied in the diagnosis and indication of complicated abdominal diseases in children