Two-hundred and sixty-four patients with typhoid perforation of the bowel, who were admitted to our department during a five-year period (1978 to 1982) were reviewed. Most of the patients presented with advanced peritonitis, severe dehydration, toxemia and gross malnutrition. History and clinical examinations were sufficient for the diagnosis of these patients. Operative management was found to be far better than conservative treatment which was associated with a very high mortality. The best morbidity and mortality levels were obtained in patients who received thorough peritoneal lavage, intravenous Metronidazole, hyperalimentation and blood transfusion. The single layer suture technique was found more effective in reducing the incidence of postoperative fecal fistula than the double layer technique.