Acute appendicitis is traditionally understood to be a clinical diagnosis. About 6% of population is expected to have appendicitis in their lifetime . Routine history and physical examination still remain most practical diagnostic modalities . Absolute diagnosis of course is only possible at operation and histopathologic examination of the specimen . For this reason it is impractical to have a definitive preoperative diagnosis by gold standard, histopathology, which leads to an appreciable rate of negative appendicectomy as reported in the world literature varying from 20–40% with its associated morbidity of around 10%, some surgeons even accept a negative appendicectomy rate of 20%. In order to reduce the negative appendicectomy rates various scoring systems have been developed for supporting the diagnosis of acute appendicitis . Alvarado scoring system is one of them and is purely based on history, clinical examination and few laboratory tests and is very easy to apply. This study was conducted on 50 patients presenting with symptoms and signs of acute appendicitis to the casualty adopting Alvarado scoring system. Our study shows Alvarado score distribution among patients. 3 patients had Alvarado score between 3-4. 21 patients had Alvarado score between 5-7. 26 patients had Alvarado score between 8-10. In our study ,Group I (Alvarado score ≥ 7) had 26 patients out of which 22 had Confirmed Appendicitis(True positive) and 04 had Normal Appendix ( False positive). GroupII (Alvarado score≤ 7) had 24 patients out of which 18 were False negative and 06 were (True negative).Alvarado scoring system is easy, simple, cheap, useful tool in pre operative diagnosis of acute appendicitis and can work effectively in routine practice.