Background: The conventional open omental patch repair is the gold standard treatment for peptic ulcer perforation (PUP). Laparoscopic management has been advocated for the treatment of perforated peptic ulcers since 1990, but many concerns still exist about the technique's viability and safety. Objective: The aim of the current study is to compare the results and outcome of open versus laparoscopic repair technique for perforated peptic ulcers. Patients and methods: A total of 73 cases with a preoperative clinically diagnosed with peptic ulcer perforation were distributed randomly into two groups to perform either open or laparoscopic repair with an omental patch comparing their operative and postoperative results. Results: In comparison to open surgery, laparoscopic PUP repair led to quicker oral eating and bowel movements, less postoperative discomfort, less superficial wound infections, fewer pulmonary and overall problems, secondary intervention, and a shorter hospital stay. Its sole drawback was a longer operating time. Conclusions: Laparoscopic technique is a safe and feasible treatment modality for PUP with superior outcome when compared to open surgery.