Aim: This prospective study was conducted in Rustaq Regional referral hospital, Oman from 01-3-2004 to 31-2-2007 to study the frequency of occult glove perforation in adult elective orthopaedic operations and to determine the efficacy of double gloving. Material and Methods: A total of 404 gloves (369 double and 35 single) used in 175 adult orthopaedic operations were examined. All gloves were tested by standardized water leak method - EN 455-1. Glove perforation rate, incidence amony surgical team members, location of perforation and duration of surgery were analysed and compared. Results: The overall perforation rate was found to be 15% with 11.6% blood contamination in our study. Surgeons had higher perforation rate (11.1%) compared to other operating team members.The index finger and thumb of the non-dominant hand had more perforations then the dominant hand. More perforations were observed in bony operations compared to other surgeries. Perforation rate was more in operations lasting for more than 90 min. The perforation rate of unused gloves was 1%. Conclusion: Routine use of double gloves during elective orthopaedic surgery is advocated. Occult perforations are unrecognized during surgery and pose greater risk. Double gloves confers additional protection especially in high risk patients and significantly reduces blood contamination. Also regular glove changing in high risk surgeries and surgeries lasting more than 2 hours is recommended.