The laparoscope provides an alternative approach to the operative management of a perforated peptic ulcer. Although the laparoscope has already proven to be an effective adjunct in the treatment of chronic peptic ulcer disease, its role in the treatment of perforated ulcers remains to be proven. This article reviews the technique of laparoscopic exploration of the abdomen with vagotomy and Graham repair in a patient who presented with a perforated pyloric channel ulcer.