Abstract Background: Perforation is a life-threatening complication of duodenal ulcer (DU), it requires immediate surgical inter-vention in most cases. Perforation occurs in 2-10% of cases of DU with a high risk of mortality, especially among the elderly. Simple closure of the perforation with an omental patch is a technically easy, reliable and preferable method. However, many authors consider laparoscopic repair of per-forated duodenal ulcer be superior to conventional open repair in terms of reduced pain, shorter hospital stay, better cosmetics and wound healing. Aim of Study: The present work aimed to elucidate the differences between open and laparoscopic repair of PDU, regarding operation time and postoperative outcome. Patients and Methods: The present cohort observational study, with a sample size of 40 patients, compared open omental patch repair, and laparoscopic repair of PDU, regarding operative time and post-operative outcome. Results: Statistical analysis of the collected data, using one way ANOVA test, elaborated a significantly reduced operative time in laparoscopy group versus open repair group. Moreover, Laparoscopy group showed less incidence of postoperative ileus, leakage and ICU admission, compared to open repair group. Open repair group showed less incidence of postoperative ARDS, laparoscopic repair elucidated a significantly less time taken for mobilization of the patients postoperatively, and reduced mean hospital stay, versus open group.