BACKGROUND: The primary aim of our study was to determine the frequency of video laryngoscopy (VL) use on the first intubation attempt for patients who underwent appendectomy for acute appendicitis at our hospital. METHODS: Patients who had an appendectomy for the indication of acute appendicitis at Baylor Scott & White Medical Center - Temple between January 1, 2021, and December 31, 2023, were included in our study. Study investigators extracted demographic, physical, and clinical data from our electronic medical record. RESULTS: A total of 533 and 70 patients had direct laryngoscopy (DL) and VL for their first intubation attempts, respectively. Among these, 518 (97.2%) and 53 (75.7%) performed with DL and VL, respectively, were successful on the first attempt ( CONCLUSION: Approximately 12% of our patients who underwent appendectomy for acute appendicitis had VL on the first intubation attempt, and these patients were more complex than those who had DL.