Gastrointestinal perforation is a common cause of acute abdomen due to peritonitis. The etiology and pathophysiology of gastrointestinal perforations is varied and can range from a small prepyloric perforation that is relatively clean to transection of small or large bowel with spillage of contents in peritoneum with gross contamination. Some of these are more common than others. Here we present 6 cases of rare perforations presenting to us in the casualty, their management and postoperative course in hospital. Methods: We will be assessing the cases of patients, their history, clinical presentation, radiological imaging who presented with acute abdomen secondary to bowel perforation and were intraoperatively diagnosed to have a rare pathology and assess the management and postoperative outcomes. Results: In this case series, 5 rare cases of GI perforations are highlighted including rare cases of posterior gastric perforation, DJ transection, jejunal transection, jejunal perforation, large mesenteric tear and sigmoid colon perforation. All these cases required a different approach in managing intraoperatively. Conclusion: Gastrointestinal perforation is a common cause of acute abdomen and requires emergency surgical intervention. CT imaging has become a fundamental part of the preoperative evaluation and can determine site and cause of perforation.Gastrointestinal tract perforations can occur due to various causes, and most of these perforations are emergency conditions that require early recognition and timely surgical treatment the mainstay of treatment for bowel perforation is surgery. Atypical presentation of perforation can be a challenge to surgeons andshould be prepared to deal with it.