Background: Choosing suture material for abdominal wall closure is crucial in determining postoperative outcomes. Closing the external oblique aponeurosis is a key step in open appendectomy, yet there remains uncertainty over whether absorbable or non-absorbable sutures offer better clinical benefits. To compare the effectiveness of absorbable versus non-absorbable sutures for external oblique muscle closure regarding postoperative pain, wound complications, recovery time, and patient satisfaction in patients undergoing open appendectomy. Methods: This prospective comparative study was conducted from January 2023 to January 2024 at Bannu Medical College attached hospital. Eighty-seven patients were enrolled and divided into two groups: Group A received absorbable sutures, and Group B received non-absorbable sutures for external oblique closure. Postoperative outcomes, including pain scores (VAS), wound infection, dehiscence, hospital stay, return to daily activities, and scar satisfaction, were recorded and analyzed using SPSS version 26. Results: Pain scores on Days 1, 3, and 7 were significantly lower in the non-absorbable group (p < 0.05). Although wound infection and dehiscence rates were slightly higher in this group, the differences were insignificant. Patients with non-absorbable sutures resumed daily activities sooner and reported greater satisfaction with scar appearance. Hospital stays were slightly shorter but not significantly different between the groups. Conclusion: Non-absorbable sutures positively impacted postoperative comfort and recovery in appendectomy patients. While both materials are safe, non-absorbable sutures may be preferable when prioritizing pain reduction and cosmetic satisfaction.