Acute appendicitis is the most common condition encountered in general surgical practice. Alvarado and Modified Alvarado scores (MASS) are the commonly used scoring systems for its diagnosis, but its performance has been found to be poor in certain populations. Hence, we compared the RIPASA score with MASS, to find out which is a better diagnostic tool for acute appendicitis in the Indian population. We enrolled 180 patients who presented with RIF pain in the study. Both RIPASA and MASS were applied to them, but management was carried out as per RIPASA score. Final diagnosis was confirmed either by CT scan, intra-operative finding, or post-operative HPE report. Final diagnosis was analysed against both RIPASA and MASS. Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value and Diagnostic Accuracy was calculated for both RIPASA and MASS. It was found that RIPASA was statistically superior to MASS in terms of Specificity (97% v/s 93%), Positive Predictive Value (96% v/s 85%), Diagnostic Accuracy (68% v/s 56%),Sensitivity (47% vs 28%) and Negative Predictive Value (57% v/s 48%). RIPASA is a more specific and accurate scoring system in our local population, when compared to MASS. It reduces the number of missed appendicitis cases and also convincingly filters out the group of patients that would need a CT scan for diagnosis.