Background: Gastrointestinal perforation is a common abdominal emergency having a high morbidity and mortality. Surgery plays an important role in the management of perforation. Gastrointestinal perforation is a common abdominal emergency having a high morbidity and mortality.Methods: 100 cases of hollow viscus perforation of the abdomen have been studied prospectively in detail during the period from May 2010 to July 2012. Cases were selected randomly from admissions in Government Mohankumaramangalam Medical College Hospital, Salem, Tamil Nadu, India. Clinical diagnosis of hollow viscus perforation confirmed by investigations or by laparotomy performed.Results: The results obtained in the present study were analysed: Among hollow viscus perforation duodenal ulcer perforation was common (52 out of 100 cases). Next being appendicular perforation. Age group of 20-40 years were affected mainly. Males are affected more than females. Signs and symptoms of acute abdomen like acute abdominal pain vomiting fever may present tachycardia, hypotension, abdominal tenderness guarding\rigidity with obliteration of liver dullness and absence of bowel sounds and absolute constipation were predominant signs.Conclusions: GI hollow viscus perforations cause significant morbidity and sometimes mortality. Hollow viscus perforation is the common cause of acute abdomen needing immediate effective surgical attention. A proper early diagnosis and adequate treatment can prevent complications. Surgical approach depends on the site, size, age of perforation and number of perforations.