Surgery is now rarely used to treat peptic ulcer disease as medical treatment with H. pylori eradication and NSAIDs is usually effective. Surgery is indicated for refractory or recurrent cases, patients needing long-term steroids or NSAIDs, or emergencies like bleeding or perforated ulcers. Common surgeries include vagotomy with drainage or antrectomy, and laparoscopic approaches are now often used. Factors like previous treatments, complications, and patient health influence surgical choice. Complications can include recurrence, postgastrectomy syndromes, or early and long-term side effects.