Summary: In this work, we consider sign changing solutions to the critical elliptic problem \(\Delta u + |u|^{\frac{4}{N-2}}u = 0\) in \(\Omega_\varepsilon\) and \(u = 0\) on \(\partial\Omega_\varepsilon\), where \(\Omega_\varepsilon : = \Omega - \left( \bigcup_{i=1}^m (a_i + \varepsilon \Omega_i) \right)\) for small parameter \(\varepsilon > 0\) is a perforated domain, \(\Omega\) and \(\Omega_i\) with \(0 \in \Omega_i\) (\(\forall i = 1, \cdots, m\)) are bounded regular general domains without symmetry in \(\mathbb{R}^N\) and \(a_i\) are points in \(\Omega\) for all \(i = 1, \cdots, m\). As \(\varepsilon\) goes to zero, we construct by a gluing method solutions with multiple blow up at each point \(a_i\) for all \(i = 1, \cdots, m\).