Appendicectomy with 29,000 procedures per annum is the most common source of emergency hospitalizations in Australia(1). However, there has been little improvement in understanding acute appendicitis (AA) pathogenesis. Past studies based on online databases (i.e., UK Biobank) highlighted that dietary patterns could significantly contribute to AA development(2). More precisely, patterns aligned with the Mediterranean Diet (MD) were found to decrease the risk of developing AA. Therefore, the aim of this cross-sectional study was to examine whether dietary adherence to the MD had an impact on AA outcomes among appendicectomy patients in South-East Queensland (SEQ). It was hypothesized that clinically diagnosed AA cases would have lower adherence to a MD in comparison to control individuals without AA history. A total of 87 patients (confirmed with diagnostic histopathological reports) were recruited before undergoing appendicectomy at the Acute Surgical Unit at the Royal Brisbane and Women’s Hospital. Another 87 Australia-residing control participants, without AA history were recruited into the study involving a dietary survey based upon the 14-Item MD Assessment Tool from the PREDIMED Study(3). The 14 questions were related to the use of olive oil, daily/weekly intake frequency of fruits, vegetables, legumes, nuts, seafood, spreads, confectioneries, red meat (including processed meat), red/white meat preference, and drinking habits regarding sweet beverages and wine. A maximum score of 14 points (indicative of the complete MD diet) and a minimum score of 0 points (indicative of a diet with no pattern recognisable as MD at all) were possible resulting in two categories defined by ≤5 points and ≥6 points defined as low and moderate-high adherence to a MD, respectively. A chi-squared test was performed to determine the relationship between MD adherence and appendiceal inflammation status. The AA group 87 patients reported in this study had their AA status confirmed with diagnostic histopathological reports provided by Pathology Queensland following surgery. For the appendicitis cohort, 62% (54/87) could be classified as low adherence whilst 38% (33/87) fell under moderate-high adherence to the MD. In contrast, the control group were categorized 48% (42/87) as low and 52% as moderate-high MD adherence, accordingly. The chi-squared analysis showed a near-significant (trend) value of p=0.07, confirming that dietary patterns maybe one of the main risk factors of developing the disease. One potential constraint of this study was that there was some discrepancy in socio-demographic characteristics between the intervention and control groups particularly relating to ethnicity, where there was a greater proportion of non-White participants recruited in the non-AA group. It is concluded that dietary patterns associated to low adherence to the MD are likely to increase the risk of developing AA in a Queensland context.