Perforated appendicitis (AP) presents a late intervention of 5 and 30%, originating an increase in mortality of 0.3% in acute appendicitis and 6.5% in the case of AP, an adequate surgical approach would decrease mortality, intrahospital stay secondary to peritonitis, sepsis of abdominal origin, abscesses, etc. For this reason, it is important to emphasize a better prognosis. Currently, studies have reported that hyperbilirubinemia produced by hepatocellular damage and intrahepatic cholestasis as a result of a decrease in portal blood flow is a predictive factor for PA. The aim of the present study was to determine serum total bilirubin levels in relation to surgical and histopathological findings, to characterize postoperative and preoperative cases, to determine whether hyperbilirubinemia is a predictor of appendiceal perforation, and to evaluate its sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Therefore, we present this retrospective study of 107 cases attended in emergency, who have total bilirubin values as part of their preoperative assessment, and who underwent appendiceal perforation.