Aim: To determine the clinical investigation of patients with acute peritonitis. Materials and Methods: This clinical study was designed to investigate acute peritonitis in 50 patients admitted to our institution. Data collection was conducted using a pre-tested proforma, which included detailed history-taking, clinical examination, relevant investigations, and treatment protocols. Patients were included in the study based on specific inclusion and exclusion criteria. Inclusion criteria comprised patients provisionally diagnosed with acute peritonitis who underwent relevant investigations and surgical intervention. Exclusion criteria included patients who were ruled out for peritonitis after investigations, pediatric patients under 15 years of age, patients treated conservatively without surgery, those who refused surgical intervention, and those deemed unfit for surgery. Results: Abdominal pain was a universal symptom among all patients. Fever was present in 80%, vomiting in 70%, guarding/rigidity in 90%, and rebound tenderness in 84% of cases. Free air on X-ray erect abdomen, indicative of gastrointestinal perforation, was found in 60% of the patients. Positive peritoneal fluid culture was seen in 50% of the cases, while elevated serum amylase levels (indicative of pancreatitis) and positive Widal tests (indicative of enteric fever) were observed in 20% and 10% of patients, respectively.The culture of peritoneal fluid showed that 50% of the samples were positive for bacterial growth. E. coli was the most common pathogen, found in 20% of the cases, followed by Klebsiella spp. (10%), Streptococcus spp. (10%), Pseudomonas spp. (6%), and other bacteria (4%). The remaining 50% of cultures were negative, possibly due to prior antibiotic administration or non-bacterial causes of peritonitis.Local postoperative complications included surgical site infections in 20% of the patients, intra-abdominal abscesses in 10%, wound dehiscence in 6%, fistula formation in 4%, and persistent drainage in 4%. Notably, 56% of the patients did not experience any local complications, indicating successful surgical and postoperative management in the majority of cases. Conclusion: The most prevalent symptom of acute peritonitis is abdominal pain, with a higher incidence in males. The preferred therapy was an appendectomy.