Acute appendicitis, the most common surgical emergency in pregnant women particularly in the second and third trimesters, remains one of the most difficult life-threatening problems for the mother and fetus. In pregnant women with acute appendicitis during the second and third trimesters, the high diagnostic error rate that is due to the clinical features of the disease, the late hospitalization of patients, and the limited possibilities of noninvasive imaging of the abdominal cavity, was an incentive to use magnetic resonance imaging in these patients. Objective — to assess whether magnetic resonance imaging can be used to diagnose acute appendicitis in patients in the second and third trimesters of pregnancy. Subject and methods. Thirty-two pregnant women with symptoms of acute appendicitis in the second and third trimesters were examined. A control group consisted of 60 non-pregnant women with acute appendicitis. A 1.5 T magnetic resonance imaging scanner was used for patient examination. A scanning protocol was designed to obtain scans by using single-shot fast spin echo and diffusion-weighted images (DWI). Ultrasound examination was performed as a screening method in all pregnant women with suspected acute appendicitis. Results. The clinical presentations of acute appendicitis in the second half of pregnancy were established to provide little information since there are many diseases that have similar clinical manifestations. Ultrasound findings indicated that only 37.5% of the examined pregnant women were diagnosed as having acute appendicitis Magnetic resonance imaging could make a correct diagnosis of destructive appendicitis surgically confirmed in 87.5% of the pregnant women; 4 pregnant women were diagnosed with typhlitis. There were no false negative magnetic resonance imaging results. Conclusion. Taking into account the high diagnostic level and accuracy of magnetic resonance imaging, it is advisable to recommend the latter as a technique for choosing a visual method to diagnose acute appendicitis in pregnant women.