Aim: An observational study of clinic-pathological and microbiological correlation of peptic ulcer perforation at tertiary center. Material and methods: An analytical investigation was undertaken at B.R.D Medical College, Gorakhpur to establish a link between the clinical and pathological aspects of peptic ulcer perforation. The study also included a microbiological analysis. Based on the findings, ethical clearance was recommended. In this investigation, the patients were categorised into two categories. This research comprised patients from group 1 who had perforation peritonitis caused by peptic ulcer perforation. The patients included in group 2 had an endoscopic diagnosis of peptic ulcer disease. Results: The mean age in pre pyloric gastric perforation was 51.96±18.27and pyloric ulcer perforation was 42.25 ±6.34. Out of 30 patients operated for Peptic ulcer perforation in this study ,On histopathological examination were found to be non specific chronic inflammatory lesions . The Sensitivity, specificity, positive productive value (PPV) and negative productive value (NPV) of diagnosing Gastritis by Rapid Urease Test are shown in Table 6. The positive Rapid Urease Test had more sensitivity of 87.5%, specificity of 92.9%, PPV of 93.3% and NPV of 86.7% in the diagnosis of Gastritis. These tests were demonstrating the accuracy of risk factors. Comparison of rapid urease test in perforated peptic ulcer diseases and Non perforated peptic ulcer disease following result can be commented on the test , sensitivity 70% specificity 46.67% positive predictive value 56.67% negative predictive value 60.87% and accuracy 58.33%. Conclusion: The current investigation has shown that perforated peptic ulcer disease (PUD) is a very dangerous condition that has significant risks of both morbidity and mortality. The prevalent symptoms were stomach pain and distension. The rate of hospitalisation was elevated among the individuals who survived. The death rate rises with advancing age, and delayed presentation and commencement of therapy heighten the risk of fatality.