Introduction: There are no clear guidelines on endoscopic surveillance of patients post appendicectomy. Many studies have shown an increased rate of polyps and malignancies in patients post appendicectomy in surveillance colonoscopy. The aim of the study is to assess polyp detection rate and rate of malignancy on routine endoscopic surveillance post appendicectomy in patients over the age of 35. Methods: This study was a single centre retrospective longitudinal study carried out at Tweed Hospital in New South Wales. Study approval was obtained from the Northern NSW LHD ethics committee. The study included all patients who underwent appendicectomy for appendicitis over the age of 35 years between January 2021 – 2023. Data was retrospectively collected and assessed as per our inclusion and exclusion criteria. Results: There were a total of 139 patients who were included in the study. There were 5 malignancies (3.5%) and 3 patients with sessile serrated adenomatous polyps (2%) in the histopathology. The overall follow up rate was 56% within this cohort. There were no malignancies found on surveillance colonoscopy. The polyp detection rate in surveillance colonoscopy post appendicectomy was 44%. Conclusion: Overall, there is a high polyp detection rate of 44% seen in patients post appendicectomy in a cohort over the age of 35 years. There are several barriers which affect the overall follow up rate. With clearer hospital protocols and education of clinicians; these rates will improve. We would recommend offering surveillance colonoscopy in patients post appendicectomy over the age of 35 years.