Acute appendicitis remains one of the most common surgical emergencies worldwide, traditionally managed by open or laparoscopic appendectomy. Over the past two decades, minimally invasive techniques have evolved significantly, culminating in the development of Natural Orifice Transluminal Endoscopic Surgery (NOTES). NOTES Appendectomy represents an innovative approach that eliminates abdominal incisions by accessing the peritoneal cavity via natural orifices such as the trans gastric or transvaginal route. This review aims to synthesize current evidence on NOTES appendectomy in the management of acute uncomplicated appendicitis, focusing on feasibility, safety, clinical outcomes, advantages, limitations, and future directions. Existing literature suggests that NOTES appendectomy is technically feasible and provides potential benefits in terms of reduced postoperative pain, improved cosmetic outcomes, and faster recovery. However, challenges related to technical complexity, infection risk, limited instrumentation, and learning curve persist. While hybrid NOTES techniques combining laparoscopic assistance have shown promising results, pure NOTES appendectomy remains largely experimental. This review highlights the current state of NOTES appendectomy and emphasizes the need for standardized protocols and long-term outcome evaluation.