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Background : Acute appendicitis (AA) is one of the most common causes of emergent surgeries. Many methods are used for its diagnosis. Objectives : This study was conducted to investigate the diagnostic value of MPV and RDW in acute appendicitis. Patients and Methods : This study was a retrospective multi-center cross sectional planned study. The study included 260 patients operated for AA and 158 patients as the control group. Groups were compared in terms of MPV, RDW, white blood cell count (WBC), neutrophil predominance (NP) and platelet count (PC). Results : MPV was significantly lower in AA group, compared to the control group (P < 0.001). The best cut-off level for MVP in AA was ≤ 7.3 fL and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy ratio were 45 %, 89.2 %, 87.3 %, 49.6 % and 61.7 %, respectively. There was no significant difference between the two groups in terms of RDW and platelet values. Conclusions : MPV is a routinely measured parameter in complete blood count (CBC) and requires no additional cost. It significantly decreased in AA, having a greater sensitivity and NPV when combined with WBC and NP.