Introduction– Concerns about the radiation exposure have led to decrease in use of computed tomography (CT) in appendicitis, with increased reliance on the ultrasound. Females with appendicitis should be risk stratified using the combination of the clinical signs and symptoms, white blood cell count (WBCs), and ultrasound in order to show further evaluation and management. Material and Methods–We prospectively evaluated the clinical guideline in female patients with suspected appendicitis. Patients were risk–stratified based on the history, physical examination findings, and laboratory results. Imaging was ordered selectively based on the risk category, with ultrasound as initial imaging modality. Computed tomography was ordered if US was indeterminate or negative. Results– One hundred and twenty patients were involved in the study with 49 patients having had appendicectomies for appendicitis while 71 were not diagnosed with apendicititis. CT usage was less in the post guideline implementation. There was not much difference between the sensitivity and the specificity of Ct and USG findings.  Conclusion– We concluded that hospitals with the high CT usage rates for appendicitis may reduce their CT usage to be reliable with national average & clinical practice guidelines