Acute appendicitis can be defined as an acute inflammation of the appendix. Acute appendicitis is the most common cause of an acute abdomen in young adults and, as such, the associated symptoms and signs have become a paradigm for clinical teaching. Appendicitis is sufficiently common that appendicectomy is the most frequently performed urgent abdominal operation and is often the first major procedure performed by a surgeon in training. The classical features of acute appendicitis begin with abdominal pain is associated with anorexia, nausea and usually one or more episodes of vomiting that follow the onset of pain. Hence based on above findings the present study was planned for Clinical Sign and Symptoms in Patients Diagnosed with the Acute Appendicitis. The present study was planned in Department of Surgery, Vardhman Institute of Medical Sciences, Pawapuri, Nalanda, Bihar. Total 20 cases diagnosed with the acute appendicitis were enrolled in the present study. All the patients were informed consents. The aim and the objective of the present study were conveyed to them. Approval of the institutional ethical committee was taken prior to conduct of this study. The data generated from the present study concludes that Pain abdomen, nausea, vomiting are the commonest symptoms. Also, the commonest sign were Tenderness over McBurney’s point and rebound tenderness observed in the enrolled patients. Advances in modern radiographic imaging have improved diagnostic accuracy, however the diagnosis of acute appendicitis remains essentially clinical, requiring a mixture of observation, clinical acumen and surgical science and as such it remains an enigmatic challenge and remainder of the art of surgical diagnosis.