French striker Perbet controlled and slotted into the corner from Danijel Milicevic's pull-back on the hour.
A strong Spurs line-up were poor for most of the evening, although Harry Kane clipped the post after half-time.
Gent, eighth in the Belgian league, almost added a second as Milicevic's shot was tipped on to the post
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The second leg is at Wembley on Thursday, 23 February.
Relive Gent 1-0 Tottenham as it happened
Spurs stutter to surprise defeat
The Gent fans were singing "we're going to Wembley" during the second half, in anticipation of next week's second leg at England's national stadium.They may have more reason than Tottenham to look forward to their big night in north London.
Spurs stumbled at their temporary European home in this season's Champions League - failing to qualify from their group after losing at home to Monaco and Bayer Leverkusen.
Having gone into the match in Belgium as second-favourites to win the Europa League, behind only Manchester United, Pochettino's team now need a good Wembley performance just to stay in the competition.
The Spurs boss will be hoping that Kane is fit for that match, having picked up an injury in the second half. Pochettino indicated that the forward may not be risked when Spurs visit Fulham in the FA Cup on Sunday.
"We need to assess Harry Kane, he got a knock on his knee," Pochettino said.
"We need to refresh the team. In the end, it is Tottenham that will play Fulham on Sunday, it's not about the name of the player."
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