Acute appendicitis is one of the most common cause of abdominal pain and one of the most common cause of surgical emergencies. Western literature reports that 6% of population had risk of suffering from appendicitis during their lifetime. Failure to make an early diagnosis converts acute appendicitis to perforated appendicitis, a disease with potential complications including intra-abdominal abscesses, wound infection, septicemia and death. AIMS AND OBJECTIVES: To evaluate the accuracy of the combined use of modified Alvarado scoring system and ultrasound in the diagnosis of acute appendicitis. • To assess the association between clinical, radiological, operative and histopathological findings and evaluation of their accuracy. MATERIAL AND METHODS: The present study was undertaken in the Department of General Surgery at Government Medical College, Jammu. All the patients who presented with right lower quadrant pain were assigned a score using the Modified Alvarado Score. . INCLUSION CRITERIA • Those admitted in G.M.C Jammu having acute lower right sided abdominal pain with a clinical and /or ultrasonographic diagnosis of acute appendicitis and who were operated for the same. • All patients who were willing to participate in the study. EXCLUSION CRITERIA • Patients who were diagnosed to have other causes of right lower quadrant pain. • Age less than 10 years. • Pregnant females. • Patients with appendicular lump. CONCLUSION: Acute Appendicitis is a common surgical emergency, mostly affecting young adults. Early diagnosis and operative intervention is necessary to prevent complications of acute appendicitis. The overall negative appendectomy rate is low but it is high in females of reproductive age group.