Background: caesarean section is one of the most commonly performed abdominal operations on women in most countries of the world. Its rate has increased markedly in recent years and is about 20–25% of all child-births in most developed countries. Aim of the work: this study aimed to assess the surgical site infection rate and patient satisfaction following closure of the subcutaneous tissue compared to non-closure of subcutaneous tissue in the diabetic women undergoing cesarean section. Patients and methods: this randomized prospective controlled study was conducted in Ain Shams University, Maternity Hospital. Elective cesarean section was done during the period from June 2016 to May 2017 to a sample of 88 pregnant women with diabetes mellitus. Results: there was no significant difference between closure and non –closure of the subcutaneous tissue in cesarean section in the diabetic women regarding SSI and wound complications. However, there was a significant difference between closure and non- closure of the subcutaneous tissue as regard the time needed for cesarean section closure which was in favor of non -closure of the subcutaneous tissue. Conclusion: closure of the subcutaneous tissue was superior to non-closure as regard patient satisfaction and cosmetic outcome. Recommendations: subcutaneous tissue closure can be used in diabetic patients undergoing cesarean section as long as it was not associated with significant increase in SSI, it had better cosmosis and patients' satisfaction.