"Organ preservation" is a term of increasing significance in GI endoscopy, inasmuch as techniques such as endoscopic submucosal dissection are able to remove early malignancies and large spreading lesions or the esophagus, stomach, and colorectum without requiring surgical resection of the entire organ. Organ preservation now has come to the appendix. No longer are the only options for treatment of acute appendicitis either antibiotic therapy or appendectomy. It is indeed possible to "unclog" an obstructed appendiceal lumen and leave a stent as treatment for acute appendicitis and avoid the need for appendectomy.