Objective To compare between Sonographic Madrid score index (MASEI) versus Spondyloarthritis research consortium of canada (SPARCC) for early assessment of enthesopathy among psoriatic skin patients. Patients and Methods This study included fifty psoriatic skin patients. All underwent history, laboratory investigation, clinical examination using SPARCC score, Psoriasis Area and Severity Index (PASI) and musculoskeletal ultrasound using MASEI score with power Doppler (PD) bilaterally for assessment of enthesitis. Results The mean age of fifty patients was 42.00 ± 10.923 years, disease duration of 11.110 ±7.402 and BMI of 29.356 ± 3.753. The mean PASI was 12.950±8.044. SPARCC score was positive in 10 out of 50 patients (20%).MASEI score was positive in 20 out of 50 patients (40%) with 10 out of 50 patients had power Doppler signals. Highly statistically significant difference between MASEI and SPARCC score( pvalue <0.001). Highly statistically significant positive correlation was observed between PASI score and MASEI(r = 0.498, p-value <0.001). Conclusion musculoskeletal ultrasound is useful for early detection of enthesitis and to be a sensitive tool in detecting of enthesitis and subclinical enthesitis that can be missed during routine clinical examination.