Abstract : Acute abdomen is a common presentation in the emergency department. Acute appendicitis is one of the commonest causes of acute abdomen. Historically, appendicitis has been diagnosed only based on clinical symptoms and signs, and with further advancements aided by laboratory variables such as leukocytes, neutrophils, and CRP. The classical presentation of pain in periumblical region shifting to right iliac fossa with tenderness at McBurney’s point is present in only 50% of cases. The signs and symptoms differ to a great extent according to the position of appendix. The present study was done at our tertiary care center as an attempt to easing the diagnosis of acute appendicitis and to compare clinical examination findings and intra-operative findings. This Descriptive Cross Sectional Study was carried out at a tertiary care hospital and research centre in a Sub-Urban area of Pune to Study The Correlation Of Clinical Signs And Symptoms Of Acute Appendicitis With USG Findings And Intra-Operative Position Of Appendix. The proposal for the study was submitted to the institutional ethics committee and study was undertaken after approval between July 2019 to September 2021. In our study the correlation between the position of appendix between clinical examination and intra-operative findings were found to be statistically significant. Thus the accurate localization of position of appendix requires an amalgamation of all modalities namely clinical examination, ultrasonography and intra-operative findings and not just one isolated modality , thereby reducing the complications associated with a missed diagnosis as well as avoiding unnecessary surgery in false positive cases ultimately reducing morbidity associated with this very much treatable condition.