Background: Most patients with chronic peptic ulcer disease have Helicobacter pylori (H. pylori) infection. In the past, immediate acid-reduction surgery has been strongly advocated for perforated peptic ulcers because of the high incidence of ulcer relapse after simple closure. Simple over sewing procedures either by an open or laparoscopic approach together with H. pylori eradication appears to supersede definitive ulcer surgery. Objective: To determine the frequency of H pylori in patients with perforated duodenal ulcer. Methods: In 30 consecutive patients suffering from acute peptic ulcer perforation the preoperative presence of H. pylori was tested. Results: The overall frequency of h pylori in patients with perforated ulcer found in this study is 83%. Our study included 30 patients with diagnosed perforated duodenal ulcer at laparotomy, of which 23 (76.7%) were males and 7 (23.3%) were females. The age ranged from 15 to 84 years. The mean age was 32.9��15.46 years. The site of the duodenal ulcer perforation was the lesser curvature in 3 (10%), first part of duodenum in 25 (83.3%), pre-pyloric in 2 (6.7%) and gastroesophageal junction in none of the patients. 18 (60%) patients had past history of gastrointestinal symptoms suggestive of peptic ulcer. 9 (30%) patients had past history of chronic NSAID use. 17 (56.7%) patients had history of smoking. 5 (16.7%) patients had a family past history of peptic ulcer. The mean age of the patients with a positive serology was 31.68��16.07 years whereas t he mean age of the patients without a positive serology was 39��11.25 years; this difference was not statistically significant; p=0.343 which could be due to small number of patients in one of the comparative groups (25 vs 5). Out of the 25 patients with a positive serology; 19 were males and 6 were females; this difference was not statistically significant; p=0.847. Conclusion: We have found a high prevalence of H. pylori infection in patients with perforated duodenal ulcers. An immediate and appropriate H. pylori eradication therapy for perforated peptic ulcers can help in reducing the relapse rate after simple closure.