Worldwide perforated peptic ulcer disease is the leading cause of mortality after abdominal emergency surgery Rapid clinical assessment, proper diagnostics, and timely decision-making are vital in handling patients with suspected or identified perforated peptic ulcer CT has high diagnostic sensitivity, whereas perforation is only evident on three-quarters of plain abdominal X-rays Delay in surgical intervention increases mortality risk Simple closure of the perforated ulcer is still the preferred method of surgery Laparoscopic surgery is the preferred approach in experienced hands