A prospective study was done to compare the postoperative morbidity and mortality in emergency and elective laparotomy in a tertiary care hospital. 72 patients were included in the study after having applied the inclusion and exclusion criteria. Out of total 72 patients 36 patients underwent emergency and 36 patients underwent elective laparotomy for gastrointestinal causes after taking the informed consent. Outcomes were assessed based upon - evaluation as well as the comparison of postoperative morbidity (complications) in elective and emergency laparotomy, to compare the mortality rate among elective and emergency laparotomy. Abdominal distension and guarding were among the symptoms and signs that were present more in cases of emergency laparotomy. Higher ASA grading of the patients were more seen in emergency laparotomy cases. Upper midline and lower midline (shorter length of incision) were more commonly performed in elective cases whereas midline incisions (lengthy incision) were more commonly performed in emergency cases depending upon the individual pathology. More number of patients following emergency laparotomy required to shift to ICU whereas spontaneous recovery was common in elective cases. In terms of complications, Grade I & II complications such as postoperative fever and wound infections were the most common complications after both elective and emergency laparotomies, but the percentage of complications was more in emergency. Grade III and IV complications were significantly higher in emergency, with wound dehiscence, sepsis and acute kidney injury being the major complications. Mortality (Grade V complication) was observed only in cases of emergency laparotomy, and postoperative stay was lengthy.