Introduction: Appendicitis  is  notorius  in  its  ability  to  simulate  other  conditions  and  also  it  can  be  mimicked  by  other  possibilities.  Although  considered  one  of  the  most  elemental  of  general  surgical  disease  processes ,  it  is  difficult  to  obtain  an  accurate  preoperative  diagnosis  in  many  cases,regularly  confounding  the  diagnostic  acumen  of  many  surgeons.  Therefore  delay  in  diagnosis  and  surgery  result  in  perforation,  the  rate  of  which  rises  by  5%  per  12  hour  period, 36  hours  after  the  onset  of  symptoms  Methodology: Patients  admitted  in  Victoria  hospital,  Bengaluru  with  features  suggestive  of  Acute  Appendicitis  and  undergoing  surgery  for  the  same  were  included  in  this  study.  For  each  patient  Alvarado  Score  was  calculated  and  the  result  of  Ultrasonography  was  noted Results: Maximum number of positive cases was associated with Alvarado Score of  5 to 7 Conclusion: Right Tenderness was more common clinical sign