Perforated peptic ulcer is the second most common complication of peptic ulcer disease, and its management can be divided into surgical and non-surgical therapy. Surgical therapy can be divided into closure of the ulcer with an omental patch, and this can be performed either as an open or a laparoscopic method. Surgical resection in the form of a partial gastrectomy is done for larger ulcers. Non-surgical treatment options include intravenous antibiotics, endoscopy, and placement of a stent, but these are selected for patients who are not fit for surgery. In this review, we will investigate the role of laparoscopic surgery in the management of perforated peptic ulcers. We will also look at the role of non-operative treatment and the role of Helicobacter pylori eradication in the management of perforated peptic ulcers.