To find out the effectiveness of ALVARADO scoring system by finding out negative groups through histopathology: A survey of patient data from a tertiary care hospital in Peshawar.

: Being one of the most common emergencies, Appendicitis results in severe abdominal pain, making appendectomy a very common procedure. The hallmark for acute appendicitis is regarded to be Right iliac fossa pain. It is a very hard job and a difficult decision for a junior doctor (in particular) whether to go for surgery or not, relying on the ALVARADO score. Therefore we aimed to find out the effectiveness of the scoring system A prospective study involving 70 patients who presenting with the clinical picture of acute appendicitis, was conducted. Two groups were made and patients were assorted according to their score. Group-A Alvarado Score > 7 (39 patients) and Group-B Alvarado Score 7 score 37 had surgery and 36 were proved to have acute appendicitis. Of the 31 patients in group-B 12 had surgery later on where 8 patients proved to have appendicitis upon histopathology. ALVARADO scoring system is an effective tool which serves for the diagnosis of acute appendicitis, which can be of prime importance in making medical decision for the patients and its further management. A score above or equal to 7 is indicative of appendectomy..