In this study group of 30 patients, eight were diagnosed with appendicular tumour, nine with appendicular abscess, five with ileocaecal Koch's, four with Carcinoma Caecum, and one with Crohn's disease. Appendicular Pathology accounts for 59% of cases appearing as a tumour in the right iliac fossa, followed by ileocaecal Koch's, Carcinoma Caecum, and Crohn's disease. This study found that appendicular mass is the most prevalent mass in the right iliac area and is best treated conservatively, resulting in a favourable response with no morbidity. All cases of ileo-caecal TB that were surgically treated showed a satisfactory response. Cases with Crohn's disease treated surgically and then followed on a medicinal regimen showed a positive response. In the event of a mass abdomen, ultrasound was found to have 89 percent sensitivity in recognizing the right iliac fossa mass, with accuracy; correct diagnosis was made in 89.3 percent and found to be superior to clinical evaluation 82 percent. Ultrasound is proven to be 89 percent sensitive in the final diagnosis. It has been demonstrated to be useful in distinguishing appendicular mass from appendicular abscess. This is a critical preoperative examination when the management strategy shifts from conservative to surgical. In our study, 20 patients underwent computerised tomography for further examination of a right iliac fossa mass in which ultrasonography was inconclusive. When compared to final diagnosis, CT was 94 percent sensitive in detecting the underlying pathology in elderly patients who cannot tolerate procedures such as colonoscopy, patients who are reluctant for radiation exposure (barium studies), and those who cannot afford CT scanning. In rural areas where CT scans are not available, ultrasound has a definitive role in the diagnosis of the right iliac fossa mass, in its pre-operative evaluation, and management