Peptic ulcer disease is commonly complicated by perforation. Mortality and morbidity arising out of these perforations can be high. Factors that influence outcome in patients with peptic ulcer perforation include treatment delay, ASA class of the patient at the time of operation and presence of shock. Of these treatment delay is most important and modifiable. This book reviews delay and how it affected outcome in patients treated for perforated peptic ulcers at the Kenyatta National Hospital, Nairobi, Kenya. In this book Patient’s files for the period January 2002 to December 2008 were reviewed. Data sought included patient demographics, clinical presentation, time from symptom onset to presentation at emergency department, time from presentation at emergency to surgical treatment and the treatment outcomes. The data is analyzed, results presented. And conclusions made. This should provide an interesting read for surgeons at various levels of training and practicing alike.