Background: Acute appendicitis is one of commonest surgical emergencies, and it is more prevalent in the second and third decades and decreasing with age. Up-till now there are no laboratory parameters that could indicate reliable for diagnosis of acute appendicitis. Several diagnostic scores have been developed to increase the diagnostic accuracy in acute appendicitis. Many studies in the literature are available on diagnostic scores for acute appendicitis as Alvarado Score & RIPASA Score. Aim of work: Evaluation and comparison of Alvarado score and RIPASA score in diagnosis of acute appendicitis to state which is more convenient in diagnosis of acute appendicitis. Patient and methods: This study was conducted on 56 patients with suspected acute appendicitis in emergency surgical department. Comparing between Alvarado, RIPASA scoring systems and histopathology of appendix of the same patient was done. Results: Statistical analysis of the data revealed that RIPASA score is superior in diagnosis of acute appendicitis with sensitivity 100% and with accuracy 88%, and negative predictive value 100% and negative appendectomy rate 4.1%. But ALVARADO score is better in exclusion of acute appendicitis diagnosis with high specificity 100% and positive predictive value 100% and negative appendectomy rate zero percentage. Conclusion: ALVARADO is sensitive in the diagnosis of acute appendicitis.