Summary: A case of typhoid perforation in a 26-day old neonate is reported. The baby Presented with a high grade and continuous fever, increasing abdominal distension, and vomiting. Intestinal perforation was confirmed radiologically and at laparatomy. Histopathology of the perforated ileum showed acute necrotizing ileitis. Baby's serum was positive for both flagellar and somatic antigens. She responded well to combined chemotherapy, consisting of intravenous ampicillin, chloramphenicol and metronidazole (Flagyl).