Background: The pattern of peptic ulcer disease and its complications has changed during the last two to three decades.Objectives: To state the frequency of acute peptic ulcer perforations and outcomes of their management at El Obeid Hospital, Western Sudan.Materials and Methods: This is an audit of patients with acute perforated peptic ulcer admitted to the emergency wards of the University Surgical Unit at El Obeid Teaching Hospital, Western Sudan during the period from January 2006 to December 2012.Results: There were 53 patients, 94.3% were males. The age ranged between 18 and 77 years. Most of the patients reported late and 45.3% during Ramadan and Shawal. All patients had emergency peritoneal lavage and simple closure with omental patch followed by anti-ulcer therapy. The postoperative mortality was 7.6%.Conclusions: Perforated peptic ulcer in this community was mainly duodenal. Emergency peritoneal lavage and simple closure with omental patch followed by anti-ulcer therapy resulted in excellent outcomes. Old age, shock, peritonitis and septicaemia were the major risk factors formortality.Key words: Perforated duodenal and gastric ulcers