BACKGROUND Peritonitis developing as a result of hollow viscus perforation is a common condition in a developing country like India. Even if the patient reaches the hospital in time and is operated, the postoperative period is still unpredictable. Secondary peritonitis is the consequence of contamination of the peritoneal cavity due to contents of a hollow viscus within the peritoneal cavity. As peritonitis following hollow viscus perforation is a life threatening condition commonly encountered in our hospital, a uniform scoring system is good to judge the efficacy of the health care as well for prognostic purposes. It helps in selecting patients at high risk who may require intensive management. Thus there has been a search for accurate risk scoring system that can be used to compare patient's outcome. POSSUM scoring system with its 12 physiological score and 6 operative score was used to predict the expected morbidity and mortality. METHODS: The present study was a cross sectional study where cases diagnosed as perforative peritonitis undergoing laparotomy in the Department of Surgery, RIMS, Imphal, Manipur, India were studied. RESULTS Out of the 100 patients in the study, 5 died and 28 had some form of morbidity. There were no patients with predicted morbidity score of less than 25. The minimum score is 6 and maximum is 48. CONCLUSIONS POSSUM scoring is a good tool to predict morbidity and mortality in patients undergoing laparotomy following hollow viscus perforation provided risk stratification is done.