Background: The aim of this study was to look at how surgical treatment of early surgery gastric ulcer perforation has changed, as well as the outcomes. While it has been demonstrated that treating perforated gastric ulcers (GUP) is feasible and effective, its adoption into routine clinical practice has been gradual. Only a few studies have looked at its overall usefulness. Material and Methods: A population-based analysis of all patients undergoing surgery for GUP between 2018 and 2020 was conducted in Rajshahi Medical College Hospital as part of a multicentered non-randomized experimental prospective study. The demographics of the patients, as well as their medical assessment, management, and results, were assessed. The following are the outcomes: A total of 482 patients were included in the study, with a median age of 67 years (range, 20–100). Results: There were 482 patients in total, with a median age of 67 years (range, 20–100). Women made up 284 (59%) of the total patients, and they were older (p0.001), had more comorbidities (p=0.002), and had a higher Boey risk score (p=0.036) than men. The position of the perforation was gastric/pyloric in 347 patients (72%), and duodenal in 135 patients (28%). A simple abdominal x-ray revealed pneumoperitoneum Thirty-one out of forty-one patients 361 patients (75%) had abdominal computerized tomography (CT) and 76 of 77 patients (98%) had abdominal computerized tomography (CT) (p0.001). 234 patients (42%) had laparoscopic surgery, which was completed in 361 patients (75 percent of attempted cases). During the study period, the rate of laparotomy care increased from 33-222 patients (7%) to 46 percent (p=0.02). Patients handled by laparotomy had a shorter median operation period (70 minutes) than those treated by laparoscopy (82 minutes) or those transferred from laparoscopy to laparotomy (105 minutes; p=0.017). In 236 patients, postoperative complications occurred (49 percent). Overall, 77 patients died within 30 days of surgery (16 percent). Both open and surgical repair, there were no statistically significant differences in morbidity and mortality. Conclusion: The increased use of clinical evaluation with X-ray (CT) as the primary diagnostic method for PPU and repair in surgical care is demonstrated in this research. Changes in management are not linked to different results.