BACKGROUND: There is a great interest in developing screening instruments for autistic spectrum disorder (ASD). Although many ASD-specific screens exist, the modified checklist for autism in Toddlers revised (M-CHAT-R) is among the most accessible. OBJECTIVES: To detect the early signs and symptoms of ASD by M-CHAT-R in children with verbal delay. PATIENTS AND METHODS: The study included 100 children with social or verbal delay between 16 and 30 months. All patients included in this study were subjected to careful history taking, thorough clinical examination, and M-CHAT-R assessment. RESULTS: Sixty patients failed to pass M-CHAT-R questionnaire, while 24 patients failed to pass CARS questionnaire. However, there was a statistically significant correlations between CARS and M-CHAT-R. In addition, there was a statistically significant agreement between M-CHAT-R and CARS regarding ASD diagnosis. M-CHAT-R had a good diagnostic reliability for diagnosis of ASD in the studied population with a sensitivity of 100% and specificity of 53 %. CONCLUSION: The modified checklist for autism in Toddlers revised (M-CHAT-R) was among the most accessible screening instruments for ASD. In addition, a statistically significant agreement between M-CHAT-R and CARS regarding ASD diagnosis. M-CHAT-R had a good diagnostic reliability for diagnosis of ASD.