Endoscopic retrograde appendicitis therapy (ERAT) could reduce complications in select patients with uncomplicated appendicitis.

• ERAT has a complication rate of only 6.3%, significantly lower than antibiotics at 37.8%.
• Appendectomy remains the best for preventing recurrence (recurrence rate 0.6% vs. 53.2% for ERAT and 2.2% for antibiotics).
• ERAT might be a safe alternative for specific patients but requires more evidence for broader use.

Choose between ERAT and appendectomy based on patient needs to minimize recurrence and treatment failures.