AIM: This study compared the short- and long-term efficacy of simple suture with omental patch repair (Graham patch) in open surgery versus laparoscopic omental patch repair (LOPR) in treating patients with Helicobacter pylori (H. pylori)-associated gastric ulcers with perforation, and analyzed the incidence of complications. METHODS: The clinical information of patients who had stomach perforation repair surgery in Deqing People's Hospital between January 2021 and January 2022 was retrospectively analyzed. The patients were divided into a control group (n = 54), whose subjects underwent the Graham patch repair, and an observation group (n = 52), whose subjects underwent laparoscopic gastric perforation repair. The general characteristics, therapeutic outcomes, intraoperative and postoperative surgical indicators, 1-year postoperative recurrence, and incidence of various postoperative complications were recorded and compared between the two groups. RESULTS: A total of 106 patients' clinical data were included in the study, of which 52 (49.1%) underwent LOPR and 54 (50.9%) were treated with Graham patch. The general characteristics of the patients in both groups were comparable. The observation group demonstrated significantly better outcomes in terms of operative time, intraoperative blood loss, and postoperative recovery time compared to the control group (p < 0.05). Moreover, the observation group had lower rates of postoperative complications and recurrence compared to the control group (p < 0.05). CONCLUSIONS: LOPR is a potential therapeutic method for patients with H. pylori-associated gastric ulcers with perforations on grounds of its superior efficacy and decreased incidence of comorbidities.