To examine the suitability of a laparoscopic approach for treatment of perforated peptic ulcer. Retrospective non-randomised study. District Community Hospital. 30 patients who presented with perforated peptic ulcers between November 1992 and October 1997 16 patients were operated on laparoscopically, and 14 by open operation (as there was no surgeon available with laparoscopic experience). Morbidity and mortality. The laparoscopic operation was successful in all but one patient, whose operation was converted to an open procedure because we could not see the ulcer adequately. Duration of operation and postoperative nasogastric aspiration, analgesic requirements, hospital stay, morbidity, and mortality were similar in the two groups. Laparoscopic repair of a perforated peptic ulcer is safe in selected patients in whom a laparotomy should be avoided.