Background: When compared to open surgery for perforated peptic ulcers, laparoscopic treatment has many advantages, including less pain, a quicker recovery time, and less consequences. Objective: This study aimed to assess the risk factors that lead to conversion of laparoscopic simple closure of perforated peptic ulcer to open procedure in Zagazig University Hospitals. Subjects and Methods: Our study is prospective randomized clinical trial was done in the General Surgery Department at Zagazig University Hospital on a study sample of 24 patients who visited an emergency room complaining of severe stomach discomfort and were told they had a perforated peptic ulcer. Those patients underwent laparoscopic repair at first. The steps of laparoscopic repair were performed after the perforation site was located laparoscopically, assuming that the initial diagnosis was correct. Results: Studied groups differed significantly regarding duration of perforation and its size, hospital stay and duration of operation. These variables were higher among conversion group than laparoscopic group. The average laparoscopic simple closure (LSC) conversion rate was 12.4% (range: 0% to 28.5%). The size of the perforation was the primary factor in most cases of conversion, however the location of the perforation was also a typical contributing factor. Only 4 of the total 24 instances in the research were converted, at a percentage of (16.7%). Conclusion: Laparoscopic management of perforated peptic ulcer is safe and practicable for the well-trained surgeon. It causes less pain postoperatively, and the rate of complications is less than an open approach.