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4% during COVID (P=0.002). Non-operative management increased during the pandemic (8.8% pre-COVID versus 16.2% COVID-era, P 0.0001). Hospital length of stay (LOS) was longer (2 days pre-COVID versus 3 days during COVID, P 0.0001). Pediatric perforated appendicitis rates did not rise during the first six months of the COVID-19 pandemic in California in this multicenter study, and there were no delays in presentation noted. There was a higher rate of CT scans, non-operative management, and longer hospital lengths of stay. Pediat