Background: The accuracy of different scores of acute appendicitis (AA) is extremely variable and sometimes unsatisfactory in different ethnic communities. The validity of the RIPSA score among the Eastern Mediterranean population is still questionable.
Objective: This study aims at evaluating The RIPASA diagnostic accuracy for AA among Egyptians.
Patients and methods: The current prospective study included 123 patients suffering from AA attending the Emergency Surgery Department. All items of the RIPASA score were fulfilled. The diagnostic cut-off score for AA by RIPASA was 7.5. Histopathological assessment for the appendix was done for all included patients and correlated to the RIPASA score.
 Results: The mean age of the included patients was 31.85 (SD 8.7) years, and 76 (61.8%) of patients were 40 years old. RIPASA score sensitivity for AA was 96.4% while the specificity was 75%. The positive predictive value was 97.27 %, while the negative predictive value was 69.23 %. The diagnostic accuracy was 94.3 %. Conclusion: RIPASA is a reliable and feasible score for AA with high sensitivity, positive predictive value, and diagnostic accuracy.