We present a case where the clinical manifestation of a duodenal perforation was masked by preeclampsia during the initial workup. A 22 year G2A1, 32 weeks pregnant female presented with symptoms of impending eclampsia and blood pressure of 190/120 mm Hg. Emergency cesarean section was done for failed induction. Subsequently, she developed subacute bacterial peritonitis leading to acute renal failure and disseminated intravascular coagulation. On post-operative day 4, the abdominal wound dressing was stained with greenish yellow discharge when the possibility of a perforated viscus was made. Laparotomy was done on day 6 and a perforation was seen on the anterior part of duodenum. Being vigilant to make an early diagnosis and intervention can reduce the maternal morbidity and mortality associated with duodenal perforation which is a rare occurrence during pregnancy.