Background: Appendectomy for acute appendicitis is one of the most frequently performed surgical precedures. The development of imaging modalities, especially that of ultrasonography and computed tomography (CT), has enabled more accurate diagnostics with a significant decrease in false positive diagnoses, which has led to lower rates of negative appendectomies. Hence; the present study was conducted for assessing the correlation of preoperative ultrasonographic findings and intra operative surgical findings in cases of acute appendicitis. Materials & methods: This was a prospective study conducted at Department of General Surgery, Rajindra Hospital, Patiala by including 50 patients presenting with acute appendicitis. A structured pre-prepared proforma was used to enter the complete history, investigations-hematological and ultrasound, intra-operative findings and histopathological report. Data collected was entered into MS-Excel 2013 spread-sheet. Results: Amongst the 50 patients taken up for surgery, 42 were found to have acute appendicitis, while 8 patients were noted to have some other diagnosis. Based on these findings, the sensitivity and specificity of ultrasound in diagnosing acute appendicitis was calculated to be 92.86% and 87.50% respectively. The positive predictive value of ultrasound, i.e. – its ability to identify acute appendicitis correctly amongst all cases of acute appendicitis diagnosed on ultrasound was 70%. Its negative predictive value, meaning, the ability of ultrasound to accurately exclude the possibility of acute appendicitis amongst all the cases that are negative for acute appendicitis on ultrasound was 97.5%. The accuracy of ultrasound in identifying acute appendicitis was found to be 92% in the current study. Conclusion: In equivocal cases sonography is better than clinical evaluation, while in unequivocal cases, ultrasound proves helpful in confirming the diagnosis.