Purpose <p>As one of the most common surgical emergencies, nonoperative management of acute appendicitis becoming more widespread. Failure rate and recurrences are main problems against nonoperative management. The aim of the current study is to evaluate long term recurrence rate of acute appendicitis after nonoperative management.</p> Methods <p>This cohort included patients treated between February 2017 and December 2021 with a mean follow up of 64.2 months. The cohort consists of patients with clinically and radiologically approved uncomplicated acute appendicitis. All patients had a course of nonoperative management with antibiotics. Primary outcome of the study is the recurrence rate of acute appendicitis. Secondary outcomes are failure rate of medical treatment and neoplasia rate.</p> Results <p>The mean age of the participants was 41.51 ± 18.7 years. The cohort consists of 51.7% male and 48.3% female patients. The success rate of nonoperative management of acute appendicitis was found to be 95.7%. At the end of the study 209 patients included in analysis with a mean follow up of 64.2 months. The recurrence rate was found as 5%.</p> Conclusion <p>Nonoperative management of uncomplicated acute appendicitis can be used with high success and low recurrence rate.</p>