Background: Ruptured appendicitis leads to longer hospital stays and is associated with many post-operative complications, morbidity, and mortality. Earlier identification and proper treatment of acute appendicitis may prevent perforation. Objectives: The study objective was to review the incidence of occurrence and leading risk factors of acute appendicitis neglected to rupture in Saudi Arabia. Methods: PubMed database and EBSCO Information Services were used for articles screening. All related papers with the subjects to study regarding the incidence of occurrence and leading risk factors of acute appendicitis neglected to rupture in Saudi Arabia and other articles have been used. We excluded additional papers that are not relevant to this topic. data of our study was collected as per the particular manner in which the group members would study it. Conclusion: There is a profound effect of acute appendicitis neglected to rupture on both patients and healthcare organizations; hence efforts should be focused on implementing complex multidisciplinary prevention strategies. We propose that health care workers in the surgical center undergo instruction to stress the importance of integrating these measures into everyday practice as well as through the quality of service provided to acute appendicitis patients and avoiding acute appendicitis neglected to rupture.