This video demonstrate Retrocecal Subserous ruptured appendix surgery performed by Laparoscopy. Although there are several factors that can contribute to this rare pathology, the main cause of neglected medical management of appendicitis is the persistence of a large appendicular lump. CT and US are very useful diagnosis tools. Treatment consists to a careful appendectomy of the subserous part of appendix which can be carried out by laparoscopic approach. In this rare pathology a prior history of appendectomy can delay the diagnosis and increase its associated morbidity and even mortality.