BACKGROUND Around 4 million people are affected by peptic ulcer diseases worldwide annually. The incidence of around 1.5 % to 3 % has been estimated. Peptic ulcer perforation presents with an overall mortality of 10 %. The management is also associated with significant post-operative morbidity and mortality regardless of whether laparoscopic or open repair is performed. In this study, we wanted to find out the incidence of peptic ulcer perforation and its management. METHODS Our study was a prospective observational study conducted in post graduate Department of Surgery, Government Medical College Srinagar, from October 2018 to November 2020. All patients were evaluated properly with all baseline investigations followed by X-ray chest and abdomen and ultrasonography (USG). RESULTS In our study, 136 patients were diagnosed as cases of peptic ulcer perforation. The maximum number of patients were in age group of 41 - 50 years (27.20 %). The male : female ratio was 14.1 : 1. Abdominal pain was present in all patients as presenting symptom followed by abdominal distension. In this study, 124 patients (91.2 %) had perforation in first part of duodenum, 9 patients (6.6 %) had perforation in prepyloric region and 3 (2.2 %) patients had perforation in body of stomach. Graham’s Patch repair was done in 133 patients, 1 patient underwent primary closure, and 2 patients underwent distal gastrectomy with gastrojejunostomy. CONCLUSIONS Our study shows that young people with perforated peptic ulcer have fewer coexisting medical illness, a lower complication rate and a more favorable outcome as compared to elderly patients with perforated peptic ulcer. A majority of such perforations are in 1st part of duodenum with male preponderance. A plain chest radiograph is sufficient to make diagnosis in the classic case of sudden onset epigastric pain. KEYWORDS Perforation Peritonitis, Management of Peptic Ulcer Perforation, Graham’s Repair, Clinical Presentation of Peptic Ulcer Perforation

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