Background: Acute appendicitis is the commonest cause of acute abdominal pain in the surgical practice. Correct clinical diagnosis prevents unnecessary surgeries and complications. Various scoring systems are there to aid clinical diagnosis of the acute appendicitis.

Methods:  A prospective observational study was carries out at the Department of Surgery, B J Medical College, Ahmedabad, from February 2018 to December 2018. Demographic, clinical and laboratory investigations’ data was collected from consenting patients. The gold standard for the diagnosis was histopathological examination. The data was analyzed by IBM SPSS Statistics (2015). Sensitivity, specificity, accuracy and negative predictive value and positive predictive value (= precision) were compared.

Results:  Majority of the patients with right iliac fossa pain were operated. RIPASA scores better than USG on all the 4 attributes viz. sensitivity (0.90 against 0.84), specificity (0.30 against 0.20), accuracy (0.80 against 0.73) and positive predictive value (= precision) (0.87 against 0.84).

Conclusion: RIPASA is not only less reliant on the technology and skill but also better in guiding the prognosis.