Acute appendicitis is the most common acute surgical condition of the abdomen. when the clinical presentationis atypical, barium enema has proven to be safe and useful in confirming the diagnosis and reducing the negativesurgical exploration. However, the performance of barium enema in acute appendicitis has known contraindicationprimarily because of fear of leakage by perforation of the inflammed appendix. This study using barium enema as adiagnostic aid in acute appendicitis with atypical clinical presentation was performed to further support thepreviously noted efficacy and safety of this procedure. The results were as followings: 1. In case of acuteappendicitis with atypical clinical presentation, the use of barium enema as a diagnostic aid increased theaccuracy of diagnosis and decreased the negative surgical exploration. In women between 11 to 50 years old age,especially, it played important role differentiating appendicitis from nonsurgical acute abdomen. 2. The resultsof the study were 92.31% in sensitivity, 7.69% in false positive, 6.9% in false negative, and 10.26% in negativeappendectomy. 4. A simple partial or nonfilling of appendix without other associated possitive finding could notexclude appendicitis, therefore, close clinial observation was necessary. 5. The positive findings of barium enemaand their sensitivity were as followings: 1. Nonfilling of appendix: 9% 2. Partial filling of appendix: 91.7% 3.Displacement or a local impression on temrinal ileum: 100% *, In all cases, combined with a local impression oncecum and/or irritability of cecum or terminal ileum.