Introduction Acute appendicitis is a common cause of acute abdomen for which a prompt diagnosis and treatment is rewarded by a marked decrease in morbidity and mortality. The present study has been planned to compare Alvarado and RIPASA scoring systems in diagnosis of acute appendicitis and correlating both scoring systems with histopathological findings. Methods 70 cases of appendicitis were admitted. RIPASA and Alvarado scores were correlated with histopathological findings. Results The sensitivity and specificity of Alvarado scoring system in our study were 82.09% and 66.67% respectively and PPV and NPV were as 98.21% and 14.29% respectively. The sensitivity and specificity of RIPASA scoring system in our study came out to be 79.10% and 100% respectively. PPV and NPV were as 100% and 17.65% respectively. The diagnostic accuracy was as 80%. Conclusion We found that RIPASA scoring has more diagnostic value in diagnosis of acute appendicitis