The population studies have shown that peptic perforation remains a major health problem worldwide. The lifetime frequency of peptic ulcer diseases in United States has been shown to be approximately 10%. The epidemiology of peptic ulcer is showing declining trend in India over last two decades. The frequencies of both duodenal ulcer and gastric ulcer showed a decline from 1988 to 2008 that is from 12% to 2.9% and 4.5% to 2.7% respectively. Although there is decreasing trend in peptic ulcer diseases, complications are encountered in 10-20% of cases and 2-14% of ulcers perforate. Peptic ulcer can occur in body of stomach, lesser curvature, and pylorus to duodenum. These perforate most commonly on anterior aspect of duodenum. However anterior or incisural gastric ulcers may perforate posteriorly in to lesser sac, which can be particularly difficult to diagnose as these may not have symptoms of peritonitis even. If peritonitis is present and perforation not found on normal course then, they should be looked over in lesser sac also.