Duodenal ulcer is common in tropical African countries. In many cases, the patients are first seen as cases of gastric outlet obstruction because, in this environment, people present at the hospital in late stages of disease. Perforated duodenal ulcer in this environment, however, has received very little attention in the literature because previously it was rarely seen. It is not unlikely that some cases of severe gastric outlet obstruction from chronic duodenal ulcer are due to unrecognized perforated duodenal ulcers that have healed.Perforated duodenal ulcer is seen mainly in males, and many of these patients have never before been diagnosed as cases of peptic ulcer disease. The disease seems to be more common in people with blood groups O and AB. The majority of cases have a positive radiological examination.As the duration of presentation is relatively long, all patients in this series are treated with satisfactory results by simple closure and abdominal toileting.Gastric ulcer was not seen during this period of review.