This study is to evaluate the role of ultrasonography versus computed tomography in the evaluation of patients presenting with acute right lower quadrant abdominal pain.60 patients complaining from acute RLQ abdominal pain were examined by CT and sonography, especially those presenting with atypical signs and symptoms and when clinicians expressed difficulties in defining the etiology due to the absence of a single confident diagnosis. The cases were referred from the out-patient clinic of Surgery, Urology, Gynecology, and from the Emergency department. The results were gathered, evaluated and discussed.It was found that CT is preferred as the initial diagnostic tool in the elderly patients especially if the patient is obese, or if the acute pathology is suspected to be of gastrointestinal origin.On the other hand, abdominal emergencies in young adults, and in women in their reproductive years, as well as acute urinary conditions can be initially explored by an abdominal ultrasound.U/S was diagnostic in 37 cases, suggestive in 8, and negative in 15, giving a sensitivity of 61.7% in RLQ disease. CT was diagnostic in 45 cases, suggestive in 6, and negative in 7, giving a sensitivity of 77.6% in RLQ disease.