OBJECTIVE: To study the incidence of malignancy as well as neoplasia in the appendicectomy specimens routinely sent for histopathology. METHODS: We conducted this retrospective cohort study of 947 patients diagnosed with acute appendicitis with subsequent appendectomy in the period between 1 January 2018 and 31 December 2022 (5 years) at Ibra hospital, North Sharqiya, Sultanate of Oman. We analyzed the clinical data of the cohort including demographic information, diagnosis, pre-operative imaging, histological diagnosis and incidence of malignancy in appendicectomy specimens. RESULTS: The median age of patients was 36.4 years (range 13-80 years). The male-to-female ratio in the appendicectomy cohort was 1.03:1. Post-operative histology revealed out of 947 cases just 8(0.8%) cases were diagnosed as cancer. Acute appendicitis 851(89.9%) and negative appendicectomy 88(9.3%). CONCLUSION: The incidental identification of appendiceal cancers in the resected specimens after acute appendicitis is not uncommon. It is recommended to consider such diagnosis when dealing with acute appendicitis in older patients with longer symptom history and in the presence of peri-appendiceal mass.