Abdominal pain, specifically right lower quadrant abdominal pain is a common presenting symptom in the pediatric emergency department (PED). While common diagnoses are more likely to be considered, sometimes, unusual causes can present with this complaint. Carcinoid tumor is the most common tumor of the appendix. It can be very difficult to diagnosis initially and is mostly discovered during surgery for misdiagnosed acute appendicitis. Prognosis is generally excellent with a 5-year survival of 94%, when tumor is confined to the appendix. For tumors <2cm in diameter and confined to the appendix, simple appendectomy is usually curative while in larger lesions or those with extra-appendiceal invasion, an appendectomy with right hemicolectomy and cytoreductive surgery is necessary. Here we discuss the case of a 13-year-old female who was discovered to have such a lesion during a laparoscopic appendectomy.