Background: Appendicitis is an inflammation of the appendix that requires a precise diagnosis to determine patient management. An appendicogram is still used as a supporting examination to assist in the evaluation of the appendix. However, there are differences between the theory (Bontrager, K. L., & Lampignano, J. P., 2018) and the practice of using radiographic projections in appendicogram examinations at the Radiology Unit of Aisyiyah Ponorogo Hospital, so a study of the examination techniques used is necessary. Therefore, this study aims to determine the appendicogram examination technique in cases of appendicitis and the reasons for using AP, Oblique, and Left Lateral Decubitus (LLD) projections at the Radiology Unit of Aisyiyah Ponorogo Hospital. Methods: This study used a descriptive qualitative method with a case study approach. The study was conducted at the Radiology Unit of Aisyiyah Ponorogo General Hospital from December 2025 to May 2026. Informants consisted of three radiographers and one radiology specialist. Informants were selected using purposive sampling based on their direct involvement in appendicogram examinations. Data were collected through observation, interviews, and documentation, then analyzed using thematic qualitative data analysis and conclusions were drawn. Results: An appendicogram was performed using barium sulfate contrast media orally and using anteroposterior (AP), oblique, and left lateral decubitus (LLD) projections. The main findings of the study indicated that the use of the oblique projection helped reduce the superposition of abdominal anatomical structures, while the LLD projection improved visualization of the appendix by utilizing the influence of gravity on the distribution of the contrast media. Conclusions: The use of a combination of AP, Oblique, and LLD projections can improve visualization of the appendix by reducing superposition of abdominal anatomy and exploiting the influence of gravity on the distribution of contrast media