Total leukocyte count (TLC) and neutrophil count are not reliable parameters in the diagnosis of appendicitis in children, necessitating a search for more sensitive criteria. This study's goal was to investigate the diagnostic value of neutrophil/lymphocyte (N/L) ratio in childhood appendicitis. The patients admitted for acute abdominal symptoms were reviewed retrospectively. Data collected included initial preoperative TLC, together with neutrophil and lymphocyte values. N/L ratio was calculated by dividing the values obtained. One hundred eighty-three of 240 patients were treated operatively and were proven as appendicitis histopathologically. The other observed 57 cases were accepted as non-specific abdominal pain (NAP). 90.2% of the appendicitis group and 12.3% of the NAP group had N/L ratio higher than 3.5. The results indicate that N/L ratio seems to be a more sensitive parameter than TLC when evaluated retrospectively. N/L ratio of 3.5 can be used in the prediction of appendicitis in children.