Aim: This study prospectively evaluates the results of laparoscopic repair for perforated peptic ulcers (PPU) in an institution. Patients & method: From Jan 1994 to Jan 2005, 291 patients diagnosed clinically with PPU were treated by laparoscopic suture repair. The initial 63 patients were recruited for a randomised controlled trial comparing open versus laparoscopic omental patch repair. After the trial, all patients with PPU were treated via laparoscopy. We excluded patients with history of upper abdominal surgery, concomitant evidence of ulcer bleeding or gastric outlet obstruction. Patients with clinically sealed off perforation were treated conservatively. Laparoscopic procedure would be converted for non-juxtapyloric gastric ulcers or for perforations larger than 10mm. Results: There were 233 male and 58 female patients treated, aged 16 to 88 year (mean=55). 177 patients had perforated duodenal ulcers, 39 prepyloric and 17 gastric ulcers. There were 53 conversions (18.2%) for large duodenal perforations (27), perforated non-juxtapyloric gastric ulcers (13), un-identifiable perforations (5), and technical difficulties (8). Ten patients underwent definitive ulcer procedures. Average operating time was 50 minutes (10-196). Post-operatively, the average analgesic requirement (by intramuscular pethidine) was 1 dose. Morbidity & mortality: There were 11 leakages from repaired site, 5 of them required re-operations. One patient developed duodenal ulcer bleeding after operation. Sixteen ASA III and IV patients died in the post-operative period. Another patient with conversion was complicated by port site herniation. Conclusion: Laparoscopic repair of perforated peptic ulcer is a safe emergency procedure in routine clinical practice for patients with perforated pyloroduodenal ulcer.