Background: Acute appendicitis is a common cause of both abdominal pain and surgical crises. Appendicitis patients exhibit a wide range of clinical signs, some of which may be mistaken for symptoms of other illnesses. This study was conducted to assess the correlation between ultrasonographic and surgical findings in patients with acute appendicitis. Materials &Methods: 70 patients age 18- 60 years of either gender with acute appendicitiswere subjected to ultrasonographic examination. Results: Out of 70 patients, males comprise 40 and females 30. The clinical findings were fever seen in 15 patients, nausea/ vomiting in 62, shift in pain in 28, loss of appetite in 51, RLQ tenderness in 65 and rebound tenderness in 47 patients. The position of appendix was pre- ileal in 3, post- ileal in 3, subhepatic in 1, pelvic in 14, retrocecal in 46, and subcecal in 3 patients. The difference was significant (P< 0.05). Sonographic diagnosis was positive in 65 cases and negative in 5 cases. The difference was significant (P< 0.05). Conclusion: In addition to clinical findings, ultrasonography has a defined role and is the best non-invasive approach for treating acute appendicitis.