Perforation of a Meckel's diverticulum is a rare complication. This case report is about a 9yr old child who presented to our emergency department with diffuse abdominal pain, vomiting and fever. He had leucocytosis and free fluid in the peritoneal cavity on USG. Erect x-ray abdomen shows gas under the diaphragm. A perforated appendix or a bowel perforation was suspected and a diagnosis of a ruptured MD was finally made by laparotomy. INTRODUCTION:MD is a true intestinal diverticulum that results from the failure of the vitelline duct (omphalomesenteric duct) to obliterate during the 5 th week of fetal development 1 . MD is the most common congenital abnormality occurring in about 2% of the population. Meckel diverticulum is typically lined by ileal mucosa, but other tissue types are also found with varying frequency. The heterotopic mucosa is most commonly gastric (present in 50% of all MD's) and pancreatic mucosa is encountered in about 5% of diverticula; less commonly, these diverticula may harbour colonic mucosa 2 . This is important because peptic ulceration of this or adjacent mucosa can lead to painless bleeding, perforation, or both.