Background: The management of acute peritonitis is primarily surgical and is based on the treatment of the cause of peritonitis, decontamination of the abdominal cavity, lavage, drainage, and is then usually continued at an intensive care unit with targeted antibiotic therapy and comprehensive intensive care. Hence; the present study was conducted for evaluating the patients with acute peritonitis. Materials & methods:The present study was a cross-sectional one involving 300 patients of more than 18 years of age and of either gender who were diagnosed with acute peritonitis. Diagnosis of peritonitis was made based on clinical and radiological findings. The aetiology of the peritonitis was determined through exploratory laparotomy. A self-structured questionnaire recorded operational findings such as duodenal perforation, ileal perforation, ileal stricture with perforation, and ruptured appendix. When surgery was necessary, the perforation's underlying cause was addressed. Following surgery, patients were watched for the emergence of problems. Results:Duodenal perforation was the most common cause of acute peritonitis found to be present in 28 percent of the patients. Typhoid perforation and ruptured appendix were responsible for 25 percent and 21 percent of the cases respectively of acute peritonitis.Overall complications were seen in 29 percent of the patients. Among the 29 patients with complications, dehydration, septicaemia, paralytic ileus and burst abdomen was seen in 15 percent, 10 percent, 3 percent and 1 percent of the patients respectively.Maximum Mortality was found more then 50 years of Male. Conclusion: Numerous disorders can induce acute peritonitis, a dangerous surgical emergency. The most frequent causes include burst appendix, typhoid ileal perforation, and duodenal perforation. By living a hygienic lifestyle, they can be prevented.