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The Portsmouth modification of Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (P POSSUM) is a scoring system that is used to predict 30 day mortality and morbidity rates in patients who are undergoing surgery. The method is used in predicting mortality and morbidity in patients undergoing surgeries in different departments like V POSSUM for vascular, CR POSSUM for colorectal surgeries. Here we have tried to evaluate P POSSUM equation in predicting mortality and morbidity in patients undergoing emergency laparotomy. During the study period, 72 emergency laparotomies were performed in our hospital .All the consecutive cases were taken for the study. P POSSUM equation was applied to all the patients and the risk of mortality was calculated. The estimated rates were compared with observed rates using linear by linear association of chi-square test. P POSSUM equation clearly predicted mortality rates with linear by linear association of chi square test with P value of ‹0.001. The ROC (Receiver operating characteristic) curve shows the predictive potential of P POSSSUM for mortality with a sensitivity of 100%, specificity of 88.89% and area under the curve 98.1%. The study shows that p possum equation predicts mortality in patients undergoing emergency laparotomies almost same as observed mortality. So if this finding is validated, it can be used in patients undergoing emergency laparotomies. KEY WORDSEvaluation, Mortality, P POSSUM, Emergency laparotomy INTRODUCTION: The Portsmouth modification of Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (P POSSUM) is a scoring system that is used to predict 30 day mortality and morbidity rates in patients who are undergoing surgery1. POSSUM stands for Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity. It was developed by Copeland et al in 1991 and has since been applied to a number of surgical groups including orthopedic patients, vascular surgery and colorectal surgery. Copeland GP explained the genesis of the POSSUM scoring system and described the correct analysis method2. He suggested usage of POSSUM scoring system to identify high risk patients who could be benefited from preoperative optimization to provide better surgical care to the patients. He concluded by suggesting wider application of POSSUM in various surgical specialties and other countries to assess the quality of care by using the difference in the Observed: Expected ratio. POSSUM was first described by Copeland et al as a method for standardizing patient’s data so that direct comparisons of patient outcome could be made despite differing patterns of referral and population3 .They originally assessed 48 physiological factors and 14 operative and post operative factors for each patient. Using multivariate analysis techniques these were reduced to 12 physiological and 6 operative factors which are summarized in TABLE 14. The P POSSUM is a 2 part scoring system that includes a physiological assessment and a measure of operative severity. The physiological part of the score includes 12 variables, each divided into 4 grades with an exponentially increasing score (1, 2, 4 and 8). The physiological variables are