Background: Appendicitis represents the most prevalent abdominal emergency. The present study was conducted for retrospectively assessing appendicitis and appendectomy in a tertiary care hospital. Materials & Methods: 100 patients who were clinically diagnosed as having acute appendicitis and were posted for emergency appendicectomy, were enrolled in the study. The assessment of patients involved a comprehensive collection of medical history, thorough clinical examination, and various diagnostic tests, including a complete blood count and ultrasonography. Each case underwent an extensive history review, focusing on symptoms such as abdominal pain, pain migration, nausea and vomiting, loss of appetite, and fever. Clinical signs indicative of peritoneal inflammation, including tenderness in the right iliac fossa, rebound tenderness, guarding, and abdominal rigidity, were noted. Upon suspicion of acute appendicitis, patients were then referred for standard laboratory tests and ultrasonography in accordance with the established hospital protocol. Appendectomy was done. Histopathologic findings were evaluated and were correlated with findings of modified Alvarado score Results: Mean age of the patients was 29.30 years. 88 percent of the patients were males while the remaining 8 percent were females. Pain RIF, migratory pain, pain on coughing and anorexia was seen in 100 percent, 80 percent, 73 percent and 86 percent of the patients respectively. Histopathology analysis revealed presence of appendicitis in 93 percent of the patients while it showed normal appendix findings in 7 percent of the patients. Sensitivity and specificity of Modified Alvarado score for identifying acute appendicitis was 83.5% and 60% respectively. Diagnostic accuracy of Modified Alvarado score for identifying acute appendicitis was 90%. Conclusion: Acute appendicitis exhibits a higher prevalence in males compared to females. The predominant symptoms typically include abdominal pain, loss of appetite, nausea, and vomiting. The Modified Alvarado score demonstrates considerable diagnostic accuracy in forecasting appendicitis prior to the performance of an appendectomy