Objective: To evaluate the anatomical positions of vermiform appendix and its association with acute appendicitis on Multidetector computed tomography (MDCT). Study design and setting: A cross sectional study based on hospital database was carried out in Department of Anatomy in collaboration with Department of Radiology, Liaquat National Hospital. Methodology: A total of three hundred and six 306 adult urban patients CT axial images were evaluated retrospectively over period of 6 months from March 2021 to August 2021 who had abdominal MDCT scan for acute abdomen after getting approval from ethical committee to find out anatomical variations of position of vermiform appendix in a tertiary care hospital among adult urban Karachi population and its association with appendicitis. Data was analyzed using SPSS version 25. All categorical variables were summarized as frequencies and percentages. Result: In present study 159(52%) were males and 147(48%) were females with mean age of 32.97 years. The subcecal anatomical position of vermiform appendix on MDCT was most common n=85(27.8%), followed by postileal n=78(25.5%), pelvic n=61(19.9%), postcecal n= 36(11.8%), preileal n=29(9.5%), ectopic n=17(5.6%). The association between appendicitis with anatomical position of vermiform appendix and age was analyzed by chi- square and was statistically significant (p =0.05). There was no significant association between position of vermiform appendix on MDCT and gender. Conclusion: The subcecal position of vermiform appendix is most common on MDCT and the postileal position was more frequent in the inflamed group of vermiform appendix
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