Background. The prevalence of pelvic inflammatory disease in combination with appendicitis (appendicular-genital syndrome) in a pediatric patient is not known and approach is not well established. Objectives. To evaluate the prevalence and clinical features of appendicular-genital syndrome in girls and develop an algorithm for diagnosis and treatment. Method. Retrospective chart review of 1833 cases of girls operated for acute abdominal surgical emergency over the 15-year period (from 1997 to 2013) in Izmailovo Children's Clinical Hospital, Moscow. Results. The incidence of combined appendicular-genital syndrome was 6% (84 patients) from the total number of cases. There were following main clinical findings related to patients withappendicular-genital syndrome: in 30 (35.7%) patients - history of menstrual irregularities, in 9 (10.7%) - history of functional ovarian cysts, in 4 (7.6%) - history of PID, body temperature was - 37.4±0.08, white blood cells - 14.8±0.53, nausea - 44 (52.4%), vomiting - 34 (40.5%) cases, pain was localized in the right iliac region - in 50 (59.5%), in suprapubical area -35 (41.7%), in periumbilical area - 27 (32.1%), and in the left iliac region - 11 (13.1%), peritoneal signs were found in 37 (44.1%) patients, symptoms related to inflammatory disease of internal reproductive organs found in 26 (36.1%). Intraoperative findings were: primary changes of the appendix were found in 42 (50%) cases, the primary changes of adnexa in 13 (15.5%) cases. Secondary changes in adnexa and appendix related to idiopathic pelvioperitonitis were discovered in 29 (34.5%) patients. Catarrhal inflammation of the appendix was detected in 9 (10.7%) cases, appendicular abscess in 16 (19.1%) cases, empyema of the appendix in 1 (1.2%) case, gangrenous form in 8 (9.5%) cases, gangrenous form associated with perforation, in 8 (9.5%) cases. Typical location appendix was found in 35 (41.7%) cases, the location of the appendix in the pelvic cavity - 33 (39.3%) cases, right adnexal involvement was detected in 36% of cases, the left - in 4% of cases, bilateral involvement was found in 60% of cases. For  appendicular form Escherichia coli (42.9%) was commonly prevalent, in genital form - hemolytic Staphylococcus aureus (38.5%), in idiopathic form - Staphylococcus epidermidis (20.7%) and Klebsiella pneumonia (17.2 %). Conclusion. The prevalence appendicular-genitalsyndrome is relatively common. Clinical features related to this pathology allowed us to distinguish few forms of this pathology, depending on the primary inflammatory location and propose diagnostic and treatment algorithm.