Acute appendicitis is the most common localized abdominal condition requiring surgery in pregnancy with a global incidence of 1 in every 1500 pregnancies; the incidence rate is 32% in the first trimester followed by 42% and 26% in second and third trimesters, respectively. Pregnancy leads to anatomical and physiological alterations that may rapidly obscure and hinder the diagnosis of acute appendicitis. Fast diagnosis of acute appendicitis in pregnancy and immediate surgery are essential for reducing the risk of perforation and peritonitis, which may increase the risk of maternal morbidity and mortality as well as consequent fetal loss. Delay in confirming a diagnosis contributes to a higher risk for perforation, and delayed surgery may cause an increase in the mortality rate to 4%. Fetal death occurs in almost 43% of all perforated appendicitis cases. Clinical manifestations of acute appendicitis in pregnancy are diverse and atypical from those found in a non-pregnant patient. Acute appendicitis is the most common localized abdominal condition that requires surgery in pregnancy. However, the diagnosis of acute appendicitis during pregnancy is challenging because of the obscure clinical manifestations and laboratory findings. Intravenous antibiotic treatment is not preferred over operation because of the poor outcome. We here present a case of a 34-year-old woman in the second trimester of pregnancy who presented with suprapubic pain and an unexpected, 3.5x2.5-cm exophytic intramural myoma on the right anterolateral wall of the uterus rather than prominent appendicitic features; thus, it took 2 days to confirm the diagnosis. Laparoscopic appendectomy was performed, and the patient was discharged without lingering complaints on postoperative day 6. Acute appendicitis during pregnancy is common; thus, attentive clinical suspicion will contribute to shorter hospital stays as well as fewer maternal and fetal complications.