Aim: To evaluate the role of laparoscopy in evaluation and management of hollow viscus perforation. Material and Methods: The present prospective study, which took place between August 2020 and September 2022 in the department of surgery at Chhatrapati Shivaji Subharti Hospital. Study participants included all patients who were offered surgical repair for a suspected perforation of the abdominal viscus and were admitted through the surgery outpatient department, the emergency room, or were transferred from other departments. Diagnostic laparoscopy was performed under general anaesthesia with intubation and controlled ventilation. For the subsequent conduct of the procedure, the choice of energy source or a combination (MEC or BEC or Harmonic) was used as per the choice of the operating surgeon. First-port findings were recorded, and subsequent disease management was decided accordingly. Results: Most common clinical feature was tenderness (90.7%) followed by vomiting (33.3%) and nausea (33.3%). Most common clinical diagnosis was Appendicitis with perforation reported in 68.3% of the subjects. Conversion to open was revealed in 11.11% of the subjects. Clinical diagnosis and intraoperative findings were matched fully and partially in 87.1% of the subjects. Radiological diagnosis and intraoperative findings were found to match in 64.9% and partly match in 18.5% of the subjects. The histopathological diagnosis and intraoperative findings were found to match in 70.4% of the subjects. Conclusion: Diagnostic laparoscopy followed by laparoscopic therapeutic intervention whenever feasible or mini laparotomy following diagnostic laparoscopy should be the standard approach for hollow viscus perforation. The diagnostic accuracy can be increased by using modern diagnostic tools especially laparoscopy.