Background: Acute appendicitis is a frequently encountered surgical disease. Detection is difficult even with imaging and blood investigations. Total leukocyte count is a promising investigation. Its role in the confirmation of acute appendicitis is investigated and analysed in the present study. Methods: Patients having acute appendicitis treated by surgical intervention (appendicectomy) were included in the study. The leukocyte count measured before surgery was compared with histopathology findings of the appendix. Parameters of diagnostic accuracy of leukocytosis were measured by standard formulae. Results: The majority of patients with acute appendicitis are below 25 years old, comprising 70% of the total patients, and males have a higher incidence of acute appendicitis at 56.67% compared to females at 43.33%. Physical findings suggest that pain in the right upper quadrant, rebound tenderness, anorexia, nausea/vomiting, and fever are common in patients with acute appendicitis. The leukocyte count (TLC) test was found to have a sensitivity of 74.69% and specificity of 38.89% in identifying cases of inflamed appendix. The positive predictive value (PPV) was high at 91.67%, indicating that if the test identifies a case as inflamed appendix, there is a high likelihood that the case is truly inflamed. However, the negative predictive value (NPV) was low at 14.58%, indicating that if the test identifies a case as normal appendix, there is a low likelihood that the case is truly normal. Conclusions: Leukocytosis alone is not a helpful investigation to support the diagnosis of acute appendicitis