Objective:　To　investigate　the　clinical　efficacy　of　transumbilical　single-incision　laparoscopic　surgery　in　the　treatment　of　complicated　appendicitis　in　overweight/obese　adolescents.　Methods:　A　retrospective　analysis　was　conducted　on　the　clinical　data　of　226　adolescent　patients　with　complicated　appendicitis　who　were　admitted　to　our　hospital　from　January　2014　to　June　2022.　Among　them,　102　cases　underwent　transumbilical　single-incision　laparoscopic　appendectomy　as　the　observation　group,　and　another　124　cases　underwent　conventional　three-port　laparoscopic　appendectomy　as　the　control　group.　The　surgical　time,　intraoperative　blood　loss,　duration　of　incisional　pain,　postoperative　flatus　time,　length　of　hospital　stay,　surgical　site　infection　(SSI),　satisfaction　with　cosmetic　result,　and　occurrence　of　postoperative　complications　were　compared　between　the　two　groups.　Results:　Both　groups　completed　the　surgery　smoothly,　and　there　were　no　statistically　significant　differences　in　gender,　age,　BMI,　duration　of　illness,　white　blood　cell　count,　and　preoperative　CRP　value　between　the　two　groups　(P　＞　0.05).　There　were　no　statistically　significant　differences　in　surgical　time　and　intraoperative　blood　loss　between　the　two　groups　(P　＞　0.05).　However,　the　observation　group　had　shorter　hospital　stays,　shorter　duration　of　incisional　pain,　shorter　postoperative　time　to　flatus,　and　lower　overall　postoperative　complication　rates　compared　to　the　control　group,　with　statistically　significant　differences　(P　＜　0.05).　The　observation　group　had　higher　satisfaction　with　cosmetic　result　compared　to　the　control　group,　with　statistically　significant　differences　(P　＜　0.05).　Both　groups　were　followed　up　for　one　year　postoperatively,　and　there　were　no　occurrences　of　residual　appendicitis　or　severe　adhesive　intestinal　obstruction.　Conclusion:　When　proficiently　mastered,　the　application　of　transumbilical　single-incision　laparoscopy　in　the　treatment　of　complicated　appendicitis　in　overweight/obese　adolescents　offers　advantages　such　as　minimal　trauma,　rapid　recovery,　fewer　complications,　and　improved　aesthetic　outcomes.　©　The　Author(s)　2024.