Background: H. pylori infection and nonsteroidal anti-inflammatory drug (NSAID) usage contribute to a great majority of cases. Thus, non-operative management of the disease is indicated in nearly all cases, with the exceptions of hemorrhage, perforation, obstruction, and refractory disease. Objective: Comparison between laparoscopic and open repair of perforated peptic ulcer as regards postoperative advantage and complication. Patients and methods: 279 identified published observational studies (randomized control trials and clinical control trials) after search strategy. Participants were patients that had done repairing of perforated peptic ulcer. Laparoscopic versus open repair of perforated peptic ulcer. Results: There was no significant difference in the operating time between the two groups (p Z 0.618). Overall, the laparoscopic group had fewer complications compared to the open group (14.3% vs. 36.8%, p Z 0.005). When reviewing specific complications, only the incidence of surgical site infection was statistically significant (laparoscopic 0.0% vs. open 13.2%, p Z 0.003). The other parameters were not statistically significant. Although total hospital costs were similar (P = .465), the median intraoperative costs were greater for LR than for OR patients, at U6772 and U5626, respectively (P < .001). The median cost of ward stay tended to be U865 less in the LR group but was not statistically relevant. Conclusion: Laparoscopic surgery had upper hand over open procedure because of less intraoperative blood loss and postoperative pain, less postoperative complications, shorter hospital stay, surgical site infection rate, shorter nasogastric tube duration.