Background: The acute physiology score is determined from the most deranged (worst) physiologic value, for example, the lowest blood pressure or the highest respiratory rate, during the initial 24 h after Intensive Care Unit (ICU) admission. The aim of present study is to apply Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system to surgical patients who have been critically ill preoperatively requiring elective surgical intervention or who underwent extensive elective surgery thereby requiring post-operative critical care monitoring and treatment in the post-operative ward or ICU or surgical ward. Materials and Methods: This prospective study was carried out on critically ill surgical patients from August 2012 to December 2013 in M. G. Hospital, Department of Surgery attached to Dr. S.N. Medical College and Associated Group of Hospitals, Jodhpur. The APACHE II score in the first 24 h of admission or operation and expected risks of death was calculated. Results: This study observed that 67.74% recovered male and 81.58% female and mortality rate increase when APACHE II score of patients increases. From the 100 patients enrolled the mean age was 47.38 ± 18.37 the overall median APACHE II score for all critically ill surgical patient was 9 with a range of 2–44 (minimum 2 and maximum 44). There was a significant difference between the APACHE II score of survivors and non-survivors. Conclusion: This scoring still provides a basic idea and uniform comparison of critical patients, thus help in research activities database validation. Few pitfalls related in the present study could have been avoided had there been large number of cases and more so of specific procedure-related patients necessitating critical care.