Introduction: Peritoneum consists of single sheet of simple squamous epithelium of mesodermal origin, termed mesothelium lying on thin connective tissue stroma. Peritoneal membrane is divided into parietal and visceral peritoneum. Parietal layer lines the abdominal wall and visceral layer covers abdominal viscera. Peritoneal cavity is the potential space between parietal and visceral peritoneum.

Methodology: This study comprises of 50 cases of acute peritonitis coming to Medical College & Hospital.A pre-tested proforma was used to collect the relevant information by history, clinical examination of patients, relevant investigations required and treatment. Patients were admitted as and when they presented with the following inclusion and exclusion criteria.

Results: Vomiting was seen with 54% of cases with duodenal ulcer perforation, 50% of cases with ileal perforation, and 50% of cases with appendicular perforation. 75% of cases of peritonitis due to other causes had vomiting. In total 56% of cases had vomiting. The next most common symptom was fever which was seen in about 50% of the total number of cases studied.

Conclusion: Guarding, rigidity, tachycardia and absent bowel sounds are most common signs seen in peritonitis.