Perforation of the appendix is an early complication of acute appendicitis; delays in diagnosis or treatment increase the perforation rate. It is unknown whether appendiceal perforation is a reflection of social inequities. It was intended to determine the association of perforated acute appendicitis in adults and equity in access to health care.Documentary retrospective cohort study type of clinical records of patients with acute appendicitis was done; the analysis was performed using Stata 11.1 and Epi-info. The results are presented in tables and figures.540 patients (292 men and 248 women)were included, the age group that most provided was that of 18-49 years (391 patients), the median time to consultation was 37.45 hours, and 5, 3 hours for passage surgery from admission; 76 echography’s, 53 CT scans, 50 interconsultations to urology and 10 to gynecology were done for diagnosis.The 18-49 age groups and the CT request were independent risk factors for perforation of the appendix.Multivariate analysis showed linear association between time of admission symptoms, socioeconomic status, time to surgery and diagnostic aid request and consultations, with good statistical significance.The perforated acute appendicitis in adults may be an indicator of health inequity.It requires multi-center studies, with longer assessment and sample size to show whether perforated appendix is a tracer of health inequalities in Colombia.