Meconium peritonitis is a rare fetal disease with an increased rate of morbidity and mortality in the neonatal period. Meconium pseudocyst is a complication of meconium peritonitis which is a sterile chemical peritonitis due to intrauterine bowel perforation. When the perforation in the intestine does not heal and communication with the cyst persist postnatal that can lead to cyst expansion, infection of the cyst or rupture of pseudocyst. This is a case report of a neonate with rupture of meconium pseudocyst causing perforation peritonitis. There was a delay in diagnosis in our case, but was successfully managed with staged enterostomy.