Objectives: This present study was to evaluate the prevalence and positive predictive value in Geisma stain of Helicobacter pylori in gastroduodenal perforation patients. Methods: A detail history, clinical examination and relevant investigation were performed to all gastroduodenal patients. And all patients managed with emergency laparotomy through midline and contaminated peritoneal fluid aspirated and the exact location and the size of perforation noted. Biopsies taken from the 3, 6, 9 o’clock positions and subjected to the Giemsa staining. Closure was done with live omental patch and peritoneal wash given and drain kept in pelvis. Patients positive for H. pylori were put on medical treatment. Results: Data was analysed by using simple statistical methods with the help of MS-Office software. All data was tabulated and percentage was calculated. Conclusions: Gastroduodenal perforation was commonly seen in elderly age group patients. Male was more preponderance than female. Duodenal perforation was more common than gastric perforation. H pylori had the high positive predictive value in Geisma stain for patients with gastroduodenal perforation. Hence, H. pylori infection is the initial or primary cause of the gastroduodenal ulceration. And, the high positive predictive value of Giemsa stain indicates potential for it being a screening test for H. pylori infections.