Background: Non-traumatic bowel perforation is a significant surgical challenge, particularly in developing countries with limited access to medical facilities. This condition is associated with high mortality and morbidity rates. Aim: Present study aimed to study the etiopathological factors responsible for non-traumatic perforation of intestine and to assess the role of histopathological examination in such cases. Material and Method: Descriptive observational study was conducted on 120 patients undergoing laparotomy for intestinal perforation. Patients undergoing laparotomy for traumatic intestinal perforation, peptic/ duodenal perforation is encountered as etiology on laparotomy were excluded from study. Result: In a study of 120 cases of non-traumatic intestinal perforations in developing countries, typhoid emerged as the leading cause, along with tuberculosis, amoebiasis, and occasional malignancy. These infections predominated as the primary culprits, with the 21-30 age group and males being the most commonly affected. Notably, the small bowel, particularly the distal ileum, was the frequent site of perforation, while large bowel perforations were rarer and typically occurred in older individuals. Conclusion: Precise preoperative diagnosis proved challenging due to nonspecific clinical symptoms, underscoring the crucial role of histopathology in guiding effective patient management, especially in cases of infectious, inflammatory, or malignant etiologies.