Gastric perforation in the neonate is rare. The authors report a 3-day-old male infant, born through a normal delivery after an uncomplicated pregnancy, who presented with a sudden gross distention of the abdomen followed by respiratory distress. Abdominal X-ray examination showed a massive pneumoperitoneum. After a brief resuscitation, an isolated perforation of the stomach was discovered on laparotomy and was sutured. Outcome of spontaneous gastric perforation in newborns is favourable provided the disease is early recognised and treated.