AIM: Aim of the present study is to evaluate the utility of US as a diagnostic method for acute appendicitis (AA) in a district general hospital, by use of accurate quality indices. MATERIAL AND METHODS: The records of all patients who underwent an appendicectomy in a one year period in a single centre were reviewed. The patients who underwent a preoperative US scan were included in the study in accordance to specific criteria and the results were statistically compared to the final surgical histology. RESULTS: 137 patients who underwent an US were included in the study, with 69 patients (23%) presenting a negative histology result. Overall, the US results correlated statistically significantly with the final histology results, with a specificity of 0.87, a sensitivity of 0.34 and an overall diagnostic accuracy of 0.51. DISCUSSION: The results of the study are comparable with the reported literature, presenting high specificity but a relatively low sensitivity, although great variability exists in the literature. US seems useful in confirming rather than excluding AA. CONCLUSION: In view of its advantages, the incorporation of ultrasonography into routine clinical practice when performed by an expert is recommended, but only in support of other diagnostic elements. The issue of low sensitivity should be further addressed.