The article generalizes experience in the treatment of 65 patients with generalized purulent peritonitis at the toxic and terminal stage with the use of active cleansing of the abdominal cavity by step-by-step lavage (1 to 12 times). The authors studied changes of the flora, the indices of immunological and nonspecific reactivity and central hemodynamics, the parameters of water spaces and electrolytes, and the condition of hemostasis from the peak of peritonitis to recovery. The cleansing step-by-step lavages of the abdominal cavity in generalized purulent peritonitis reduce the frequency and intensity of surgical complications, make it possible to avoid generalization of the septic process or its further development, and are, on the whole, an effective method of treatment. They may be considered to be method of choice in patients with polyorganic insufficiency.