Introduction: to ascertain prognostic indices and risk factor of matality in non-traumatic bowel perforation in children Methods: We reviewed a 5 years records of children under 15 years old admitted to Chang Gung Memorial Hospital with non-traumatic bowel perforation from 1998 July to 2003 June. 33 patients was collected with 33 patients with bowel perforation were collected (Age from prematurity 26 weeks to 15 years old). 2 cases (6%) was expired post-operation 24 hours. The data collected including the age, white blood cell count, number of perforation, culture result, imaging finding, dehyration grade (Blood urea nitrogen, urine output), vital sign (blood pressure, heart rate), genralized peritonitis. A statistical analysis of the results was performed by Chi square and the Students’s t test. Results: 21 case was related to infection (enterocolitis), the others are related to adhesion ileus, intussusception, volvulus, necrotizing enterocolitis. 6 cases expired and 2 of them expired within 24 hours postoperation. In the 2 motality case, one with hypotention despite inotropic agent and fluid challange before operation, the other recieved surgical intervation 2 days before perforation. With the enetrocolitis like Infection (21 cases), 5 with Salmonella infection, 2 with pseudomonas, 1 with E. coli, 1 with Clostridum Septicum, the other was mixed flora. Multiple perforation in 5 cases. The site of perforation was most in Colon with 13 casees. Pneumoperitoneum was found in 19 cases before operation. Inotropic agent was used in 2 case preoperation. The mortality rate was worsened by unstable vital sign (p<0.05) and postoperative bowel perforation (p<0.05). Conclusion: The non- traumatic bowel perforation remains a fatal illness. More aggressive fluid and eletrolyte resuscitation with antibiotic regimen are well accepted to improve the survival rate in bowel perforation. But if patient had unstatble vital sign (hypotention) or recently abdominal stress (operation ) before operation, it may be a poor prognostic factor and with high mor-taloity