Background Appendicitis is the inflammation of the vermiform appendix and is the leading cause of acute abdominal pain in young adult and is most common surgical emergence in which about 250,000 cases reported in United States and about 40,000 cases reported in England each year. It became serious when it became perforated which later on can lead to peritonitis Main symptom and cardinal features of appendicitis are pain in periumbilical region which migrate to right iliac fossae, nausea, vomiting, rebound tenderness and low grade fever , On physical examination the following can be elicited muscle guarding, rebound tenderness, Pointing sign, McBurney’s signs, Roving’s sign, Psoas sign and Obturator sign The main causes of appendicitis are fecolith matter impaction, enlargement of lymph nodes and tumors. Treatment option for patient diagnosed with appendicitis is antibiotic treatment and appendectomy Objective To determine the etiology and management of appendicitis among patients admitted at KCMC surgical department from January 2014 to December 2015. Methodology This was hospital based retrospective cross sectional study in which registration number of patient with appendicitis found from KCMC Surgical department was taken to medical record department of corresponding files of patients who presented with appendicitis at KCMC during study period and information collected in the data collection tool then entered in the computer in the format of SPSS where data was cleaned and coded for analysis using SPSS version 20. RESULTS In current study it was found that the most affected age group with appendicitis was (18-64 year) which account about 85 (81%) patient followed by (10-17) years which account 16 (15%) patient those of 65 and above were 4(4%) patient. Females were more affected in which they account 57[54%] patient .Out of 105 patient 81(77%) patient were from Moshi. The most common cause of appendicitis was found to be bacterial which it account 70(67%) patient followed by fecal matter impaction which account 35(33%) patient where other causes of appendicitis like tumor and worms are not documented in the files. Management offered were surgical intervention and conservative in which about 91(87%) patient had appendectomy. Among patients who underwent surgical appendectomy, 60 (66 %) patient were treated by open appendectomy, 31(34%) patient were treated by Laparoscopic Appendectomy and 14(33%) patient were treated conservatively. CONCLUSION The common cause of appendicitis is bacterial infection followed by fecal matter impaction. Medical management has little effect on treatment of appendicitis and surgery remained to be the best treatment of Appendicitis.