The diagnosis and treatment of acute appendicitis have changed considerably with years. In previous days the timing of surgery was under debate.. The debate on timing of the operation is nowadays settled in favour of acute operation, but the price paid for this dogma of emergency surgery for suspected appendicitis is a high rate of unnecessary appendectomies. The goal of therapy is early diagnosis and prompts operative intervention. However many patients do not seek medical attention in a timely manner and since the diagnosis of appendicitis can be difficult especially in patients at extremes of age and in those presenting with subtle and / or equivocal signs. To minimize this diagnostic dilemma, a number of scoring systems have been devised as aids to the early diagnosis of acute appendicitis. Alvarado, Teicher, Leindberg, Christian Fenyo, to name a few of these Alvarado score remains the most widely accepted one. Methods: Aim and objectives: To study 75 patients of suspected appendicitis using modified Alvarado scoring system, assessing the accuracy of modified Alvarado scoring system. Results: The result of present study showed that a high score (>7) was a satisfactory aid in the early diagnosis of acute appendicitis, the overall sensitivity in men with scores >7 was 90%, with a negative Appendicectomy rate of 10 Conclusions: modified Alvarado score is accurate in assessing acute appendicitis at high scores (>7).