Aim: The purpose of the present study was to evaluate the incidence as well as prevalence of perforation peritonitis in a tertiary care centre. Methodology: This descriptive cross-sectional study was conducted from 2021 to 2022 with a sample size of 30 patients. All details of the patients including clinical history, examination findings, laboratory and radiological investigations, intra-operative findings, and post-operative complications were studied. Results: Perforation peritonitis had a male: female ratio of 3.29:1; and was more commonly seen between the age group of 21-30 years, whereas peptic ulcer perforation had a bimodal distribution (21-30 years and 51-60 years). Commonest aetiology was peptic ulcer perforation, followed by appendicitis and enteric fever. Majority of patients presented after 48 hours, in the stage of established generalised peritonitis. The diagnosis was possible by pneumoperitoneum on X-ray abdomen standing in 70% and only a few needed CT for diagnosis. Laparotomy followed by primary closure of perforation with or without live omental patch was the commonest procedure