['Observation and repeated examination may lead to favourable clinical outcomes in the ever-challenging diagnosis of appendicitis. The goal of this study was to evaluate clinical performance in the diagnosis of suspected appendicitis in a centre with limited access to medical imaging technologies and to identify factors associated with complicated cases.', 'A retrospective review of the medical records of 211 consecutive surgical cases of suspected appendicitis, spanning an 11-year period, was performed. The delays before treatment and the subsequent patient outcomes were evaluated.', 'There were 8.1% of cases with negative findings on appendectomy, 75.8% with uncomplicated appendicitis, 12.3% with complicated appendicitis and 3.8% with other surgical conditions. The delay before the first medical consultation was significantly longer in patients with complicated appendicitis. The various delays after the first medical consultation did not differ significantly between the groups.'] Does clinical judgment remain of great value in the diagnosis of acute appendicitis?