Appendiceal anomalies are extremely rare malformations that are usually found in adult populations as an incidental finding. Agenesis and duplication of the appendix have been well documented, but we know of only three reported cases of a horseshoe appendix. A 64-year-old woman admitted to the emergency department. A provisional diagnosis of acute appendicitis was made, and the patient was taken to the operating room. While appendectomy was being performed with a standard approach, the distal tip was seen to communicate with the cecum by another stump, or "horseshoe appendix". The aim of this report is to share our experience with this extraordinary finding.