Gastric perforation with necrosis caused by acute massive gastric dilatation is an extremely rare presenting scenario. We experienced a rare case of gastric perforation caused by acute massive gastric dilatation after a binge–eating episode. A 43–year old men was admitted with a chief complaint of acute abdominal pain with severe abdominal distension after a heavy meal 1 day back. he had no history of abdominal surgery. On computed tomography, the stomach and the duodenum were severely dilated with food content. There was no tumor in the peritoneal cavity. Emergency laparotomy was planned . Laparotomy revealed that the stomach were severely dilated. There was a small perforation  on the prepyloric region of the stomach. We performed decompression through intra operative guided ryles tube aspiration and graham patch closure was performed. The patient’s postoperative recovery was uneventful. surgeons should be aware that binge–eating habits may cause acute massive gastric dilatation in the absence of a typical eating disorder history and may result in acute abdomen conditions like gastric perforation or gastric necrosis