Introduction and Objectives; Appendicitis is one of the commonest disease faced by surgeons. Alvarado scoring system is one of the most commonly used scoring tool which incorporates symptoms, signs and laboratory investigations to reach the diagnosis1. Objective of this study was to determine the usefulness of RIPASA score for the diagnosis of acute appendicitis using histopathology as a gold standard. Materials and Methods; In this prospective study over 9 months, 100 cases of acute pain in right iliac fossa, admitted in a tertiary teaching institute, from February 2017 to October 2017 were studied. Exclusion Criterion: Patients with appendicular lump, Pregnancy. Results; The sensitivity of RIPASA score in diagnosing acute appendicitis at cutoff value of 7.5 is 98.80%, the specificity is 87.5%, positive predictive value is 97.64%, negative predictive value is 93.30% and false positive rate is 12.5%. Area under the curve (AUC) is 0.914 in ROC with 95% confidence interval and p value <0.05 and is considered statistically significant. ROC analysis was done to depict the cut off with maximum sensitivity and specificity & was found to be7.5. Conclusion; On correlating RIPASA score with the histopathological report, the sensitivity and specificity of RIPASA score in diagnosing acute appendicitis at cut off 7.5, is 98.8% and 87.5% which is also comparatively better than other routinely used scoring systems.