Background: Acute appendicitis is one of the most common surgical emergencies encountered in the world particularly among young adults and children. The present study was conducted to assess predictive accuracy of RIPASA versus Alvarado and AIR Scores in diagnosis of acute appendicitis. Materials & Methods: 67 patients presenting with right iliac fossa pain in the department of general surgery of Sharda Hospital, Greater Noida undergoing conservative treatment were enrolled. AIR and RIPASA score were calculated. For each scoring system, specificity, sensitivity, positive and negative predictive values of each score was calculated. Results: There were about 64.2% males and 35.8% females. Total mean RIPASA score was 10.01±1.94. Total mean Alvarado score was 7.93±1.17. Total mean AIR score was 6.69±1.77. In patients with RIPASA score >7.5, appendicitis was seen in 59 and normal appendix in 1. Sensitivity was 92.19% and specificity was 66.67%. In patients with Alvarado score >7, appendicitis was present in 53 and normal appendix in 1. Sensitivity was 82.8% and specificity was 66.67%. In patients with AIR score >8, appendicitis was present in 15. Sensitivity was 23.4% and specificity was 100%. Conclusion: This study validates that the Raja Isteri Pengiran Anak Saleha Appendicitis score and Alvarado score have strong discriminating powers and surpass the appendicitis inflammatory response score.