Aim: To assess the role of USG and MDCT in diagnosing the etiology of acute right lower quadrant pain and to suggest the mode of management. Material and Methods: 100 patients were studied in the Post Graduate Department of Radio–diagnosis and Imaging, Government Medical College, Jammu over a period of one year. All patients presenting with acute right lower quadrant pain were included in the study except; (i) who refused to give consent, (ii) who had documented allergic reaction to contrast material, (iii) multiple myeloma patients, (iv) pregnant females and (v) patients having renal impairment. An adequate history was elicited, followed by a focused clinical examination and relevant ancillary investigations of every patient was done prior to USG and MDCT. An attempt made to compare MDCT findings with clinical, ultrasound and operative findings wherever surgery was done. Results: A total of 100 patients (54 male & 46 female) were included in study with 65% of them falling between 21–40 years age group (Range 12–70 years) who had undergone both ultrasound and MDCT for RLQ pain. Besides abdominal pain the associated symptoms in the study group were fever (57%), vomiting (39%), anorexia (15%), weight loss (15%) and diarrhea (2%). Acute appendicitis (25%), appendicular lump (16%), ileoceacal tuberculosis (15%), urolithiasis (11%) were the commonly seen pathologies. Conclusion: MDCT has diagnostic advantages in bowel pathologies like appendicular inflammation, ileocecal tuberculosis, right–sided colitis with or without abscess formation, pathologies and ureteric stones. USG is equally good to MDCT in diagnosing mesenteric lymphadenitis, intussusceptions and various gynecological causes of right lower quadrant pain. MDCT however is associated with hazardous radiation exposure and may be reserved for patients with non–diagnostic USG results, making USG the first line investigation