Background: Acute inflammatory conditions are one of the most common problems faced in the clinical setting. Plasma cholinesterase has been shown to have variable correlation with chronic inflammatory conditions like Diabetes, Alzheimer’s etc. This study aims to assess its correlation in acute inflammatory conditions like sepsis Objective: To assess the usefulness of Cholinesterase as a marker in Acute Inflammatory conditions. Methodology: The correlational case control study involved 30 patients admitted in the surgery & medicine departments with complaints of fever, abdominal pain & cough. Total leucocytic count (TLC) and plasma cholinesterase were determined and the results were compared with 30 ages and sex matched healthy people taken as controls. Results: There was a moderate negative correlation between CHE & TLC in cases (r= -0.567, p< 0.05). Unpaired students t test (T= 3.194, p< 0.05) showed a significant difference in CHE values in cases in comparison to controls. Finally the ROC analysis showed that AUC for CHE in cases was 0.7, indicating a fair test with sensitivity of 50% and a specificity of 100%. Conclusion: In our study it was found that the correlation of plasma cholinesterase was more with the cases than for the controls. Because the correlation is not very strong, doing cholinesterase in isolation for sepsis is not recommended. Also it was found that even though CHE levels had moderate sensitivity but had high specificity enabling us to at least rule out acute inflammation.