Background: Acute appendicitis is the commonest surgical emergency worldwide and an acceptable negative appendectomy rate is 15-20%.The diagnosis of acute appendicitis is based on signs and symptoms whose interpretation is sometimes subjective (anorexia) and varied (pain perception, referral) and thus the diagnosis of appendicitis has always been a challenge to emergency surgeons. The difficulty in availability of the investigations and the costs incurred are a deterrent factor for most of the emergency units across the world and hence a need for a comprehensive scoring system for the diagnosis of acute appendicitis is the matter of the relevance today. Aim & Objective: To study the diagnostic accuracy of RIPASA score with comparison to ALVARADO score in the diagnosis of acute appendicitis