Objective: To determine the role of ultrasound examination in verifying different common causes of RLQ pain using different techniques of examination such as graded compression and TVUS. Complementary colour Doppler was done.Patients and Methods: The study included 50 cases presenting with RLQ pain. Gray scale and colour Doppler sonographic criteria were correlated with the clinical and histo-pathologic diagnosis.Results: The sensitivity and the specificity of ultrasound examination in this study were 97.9% and 100% respectively. The most sensitive sonographic criteria of acute appendicitis were mural thickening, the presence of periappendiceal fluid collection and increased vascularity by colour Doppler study. The presence of gestational sac and empty uterus were diagnostic of ectopic pregnancy in the presence of positive pregnancy test.Conclusion: Abdominal ultrasound using graded compression technique could help in detecting cases of acute appendicitis and differentiating them from other gastrointestinal or gynecological lesions. Transvaginal ultrasound study was a great help in verifying different gynecological lesions. The presence of bowel wall thickening is suggestive of inflammatory bowel disease which needs further evaluation by other imaging modalities. Lower ureteric radio-lucent stone could be detected by US.