Although a death rate of zero is theoretically attainable in acute appendicitis, deaths still occur, some of which are avoidable. The death rate in simple acute appendicitis is approximately 0.1% and has not changed significantly since 1930. Progress in pre- and postoperative care—particularly the emphasis on fluid replacement before operation—has reduced the death rate from perforation to about 5%. Nonetheless, postoperative infections still occur in 30% of cases of gangrenous or perforated appendix. Although most of these patients survive, many near fatalities require prolonged hospitalization. The substantial increase in tubal infertility that follows perforation in young women is also avoidable by early appendectomy.