Background: Pediatric appendicitis score (PAS) is a scoring system which includes symptoms, physical examination and laboratory tests in children suspected to have appendicitis. The objectives of this study were to analyze the diagnostic value of Paediatric Appendicitis Score and to aid early diagnosis of appendicitis.Methods: A prospective study was done in a Medical College hospital, in Mangalore in children aged between 4-16 years, admitted during study period June to December 2016, with right Iliac fossa pain, suspected to have appendicitis. Data from the children including demographic details, clinical features, laboratory investigations and ultrasound done were recorded in proformas after consent from parents. The PAS score was applied to them. If PAS was between 4-6, PAS scoring was repeated after 6 hours. Investigations done were noted. If child was taken up for surgery, histopathology report of the biopsy specimen was collected. The decision to operate or manage conservatively was taken up by the treating pediatric surgeon. PAS score was compared with ultrasound and biopsy report.Results: Sixty children were included in the study. Anorexia, emesis, migration pain, cough tenderness and leukocytosis were the features most consistently seen in appendicitis. Initial PAS were comparable to the repeat scores. Ultrasound showed presence of appendicitis in 88.3% of the children. Ultrasound showed appendicitis in all children with PAS ≥7. Twenty-six children out of 60 underwent surgery. Out of 20 children with PAS ≥7.15 (75%) were taken up for surgery and biopsy showed appendicitis. Biopsy was done in 26 children, of whom 58.1% had PAS ≥ 7. These findings were statistically significant. Conclusions: Paediatric appendicitis score is a valuable tool in diagnosing childhood appendicitis.