Background: Perforation peritonitis is a common surgical emergency. Laparotomy has been the gold standard for the definitive management. However in high risk patients there are various alternatives to immediate laparotomy are present like primary peritoneal drainage (PPD), laparoscopic sanitation; Taylor’s conservative method, laparotomy and planned re-laparotomies. Objective: To study the no. of patients survived & expired and change in blood parameters and vitals after insertion of pre-operative intra-abdominal drain. Material and methods: This is a prospective study in which patients presenting with clinical suspicion of perforation peritonitis in the department of Surgery, Guru Nanak Dev Hospital/ Govt. Medical College, Amritsar. Patients were subjected todetailed history, thorough physicalexamination, blood investigations like cbc, rft, serum electrolyte and radiological investigations like xray abdomen, USG abdomen/pelvis CT-abdomen. All diagnosed patients will be subjected toinsertion of intraabdominal drain under local anesthesia. Results: The pre-operative intraabdominal drain in unfit patients improves the blood parameters and vitals thus decreasing symptoms and morbidity. Conclusion: The various co-morbidities and unstable vitals of patients are often hurdles to the surgeon to decide whether to operate or wait or not to operate. So in mean time pre-operative intra-abdominal drain help in improving overall status of such unstable patients.