Background: Peptic ulcer perforation remains a significant clinical problem with high morbidity and mortality rates. Several scoring systems have been proposed for assessing the severity of peptic ulcer perforation, including the Boey, POMPP, and PULP scores. This study aimed to compare the effectiveness of these scoring systems in predicting postoperative morbidity and mortality. Methods: This prospective study included 60 patients with peptic ulcer perforation who underwent surgery. The Boey, POMPP, and PULP scores were calculated for each patient. The sensitivity, specificity and accuracy of each scoring system in predicting postoperative morbidity and mortality were compared. Results: The PULP score was found to be a better tool for assessing the severity in peptic ulcer perforation patients compared to the Boey and POMPP scores. In patients with severe perforated peptic ulcer the PULP score had a higher sensitivity (88.9%) and accuracy (78.3%) in predicting postoperative morbidity and mortality. The Boey score had a lower sensitivity (77.8%) and accuracy (68.3%), while the POMPP score had a lower sensitivity (66.7%) and accuracy (60.0%). Conclusion: The PULP score may be a more effective tool for assessing the severity in peptic ulcer perforation patients compared to the Boey and POMPP scores. Factors that may affect the accuracy of each scoring system were also identified. Further studies with larger sample sizes and a wider range of scoring systems are needed to confirm these findings.