Introduction: Despite the widespread use of antisecretory agents and eradication therapy, the incidence of perforated peptic ulcer has changed little. Since the initial reports of successful laparoscopic management of perforated duodenal ulcers and perforation peritonitis several larger comparative series have been published confirming the technical feasibility and advantages of laparoscopic approach. Objectives: The aim is to compare the outcome and efficacy of laparoscopic repair with conventional laparotomy in the management of peptic perforation. Methods: The study was conducted on patients with diagnosis of peptic perforation in Hi-tech medical college and hospital, Bhubaneswar. It is a retrospective and prospective study from September 2012 to April 2014. Result: 50 patients of peroration peritonitis were operated randomly by laparoscopic repair and laparotomy. It was found that the laparoscopic repair of perforated peptic ulcer was associated with less intra operative blood loss, no intra operative complications, minimum post operative complications, minimum postoperative pain which was significant as compared to laparotomy repair. Conclusion: Laparoscopic repair of perforated peptic ulcer could be considered as a treatment option in routine clinical practice in the management of peptic perforation peritonitis.