Background: Acute appendicitis is the most common cause of abdominal emergency in both developed and developing countries, yet its diagnosis remains challenging. Several scoring systems have been developed in order to aid the decision-making process to reach diagnosis of acute appendicitis in the quickest way, which include the Alvarado Score, the AIRS Score, and the RIPASA Score. The current study compares and assesses the utility of the scoring systems in establishing a diagnosis of acute appendicitis, as compared to a final histological report