Abstract: Background: Harold Ellis in 1989 said, “the treatment of acute appendicitis is appendectomy – and the sooner it is done, the better.” Delayed diagnosis is associated with increased risk of having a complicated appendicitis, often, a perforated appendix. The desire to make an accurate and prompt diagnosis of acute appendicitis, reduce negative appendicectomy rate and improve the operative morbidity associated with surgery for appendicitis; has remained aflame in surgeons. This desire is almost unmet, especially, in the early stages of appendicitis, in females of reproductive age and in children. In this cohort of patients, making accurate preoperative diagnosis is difficult, because of atypical presentation and the presence of swathes of differentials with similar clinical symptoms and the occasional failure of simple radiological tools like Ultra Sound Scan(USS), to clinch the diagnosis. It is therefore imperative to probe the reliability of clinical assessment in making an accurate diagnosis, especially, in areas where the reliability of the results of USS is not strong and there is dearth of high resolution radiological tools of assessment, such as; Computed Tomography (CT) and Magnetic Resonance Imaging(MRI). Objectives: We aim to correlate the clinical and histopathological diagnoses .....................