Carcinoid tumors are the most common neoplasm of the vermiform appendix, with most found incidentally after surgery for appendicitis. To determine in patients presenting with appendicitis if incidental carcinoid tumors affected presentation or prognosis, we reviewed our experience. Of 1350 patients receiving an appendectomy from 1992 to 2000 for appendicitis, 20 were found to have appendiceal carcinoid tumors. Comparing tumor patients to 251 consecutive patients whom underwent appendectomy without tumors, we found patients with tumors were older at presentation (41 ± 4 versus 30 ± 1 years, P = 0.005) and had initial lower white blood cell (WBC) counts (10.8 ± 0.8 vs. 14.2 ± 0.3, P = 0.007). There was equivalent survival between patients with carcinoid and without. Therefore, these data suggest that patients with carcinoid tumors are older and have lower WBC counts at presentation with appendicitis, although outcome was not affected by their presence.