From, 1971-1979, 14 patients with non-traumatic perforations of the small intestine were treated in the Department of General and Abdominal Surgery of the Universitäts-klinik Frankfurt/Main. In 8 cases suture and by-pass, and/or interval operation with enterostomy was performed. Seven patients survived, one patient died. In 6 other patients resection with primary anastomosis or suture were performed. One patient survived and five patients died following peritonitis due to lack of the anastomosis. The problem of non traumatic perforation of the small intestine was discussed and corresponding literature was reviewed. It is suggested and corresponding literature was reviewed. It is suggested, that suture of perforation with by-pass or two stage operation with enterostomy is the operation of choice.