Background: Acute appendicitis is one of the commonest causes for acute abdomen in any general surgical practice(1,2). From the time that it was first described by Reginald Heber Fitz in 1886(3).Aims and objectives : To assess the RIPASA scoring system and the Modified Alvarado Scoring System (MASS) for the diagnosis of Acute Appendicitis, and compare them with respect to 1) Sensitivity 2) Specificity 3) Positive predictive value 4)Negative predictive value 5)Diagnostic Accuracy. MATERIALS & METHODS: This is a cross-sectional, comparative study conducted at ESIC Medical College & PGIMSR, K.K.Nagar, Chennai-78 for a period of 1 ½ years, from November 2013 to May 2015.RESULTS: Finally, out of the total score, the patients were categorized under 4 categories. 4% of the patients had a score of >12 and were categorized as D, 21% with a score of 7.5-12 fell under the category HP, 39% had a score of 5-7.5 and were categorized as LP and 36% with a score <5 were termed U. 81%,53%,47% and 48% had RIF tenderness, fever, raised TC and nausea/vomiting respectively. 23% patients had migratory pain and anorexia and about 17% had rebound tenderness. Conclusion: RIPASA is clinically and statistically a better scoring system for the diagnosis of acute appendicitis, as compared to MASS.