ObjectiveTo analyze the prevention value of endoscopic retrograde appendicitis treatment （ERAT） for postoperative infection of patients with appendicitis. MethodsA total of 71 patients with acute appendicitis were selected and divided into two groups， 35 patients in the observation group were treated with ERAT， and 36 patients of the control group underwent laparoscopic appendectomy. The operation indicators， postoperative adverse events， pain scores， and levels of serum inflammatory factors were compared between the two groups. ResultsThe observation group got a longer operation time， less bleeding， shorter in-bed and hospital stay， and lower hospital cost （all P＜0.05）. The main postoperative adverse event was recurrence in the observation group and infection in the control group， and the total adverse event rate was no significantly different between the two groups （P>0.05）. Twelve hours after treatment， the pain score of the observation group was lower than that of the control group （P＜0.05）. The post-operational serum levers of hypersensitivity C reactive protein， interleukin 1β， interleukin 6， and tumor necrosis factor α decreased in both groups， while the serum levers of interleukin 4 and interleukin 10 increased， especially in the observation group （all P＜0.05）. ConclusionERAT is more conducive to balance serum inflammatory factors and stabilize immune function compared with laparoscopic appendectomy， which can effectively prevent postoperative infection.