Background: Subcutaneous wound drains have demonstrated a high degree of efficacy in a number of surgical procedures. However, wound drains' usefulness in gynecological surgery, such as caesarean section, remains debatable. Objective: The aim of the current study was to assess the role of subcutaneous negative pressure drain in wound healing following major gynecological surgery. Patients and methods: A randomized controlled clinical trial was carried out at Obstetrics and Gynecology Department, Zagazig University Hospital. This study included 60 cases, divided in 2 groups, 30 cases in each group; Group 1 included subcutaneous negative pressure drain patients who have undergone subcutaneous tissue re-approximations and Group 2 included cases who have subcutaneous tissue re-approximation only. Results: Statistical significant differences were found of body mass index and age between studied groups. There is a significant difference between the two groups regarding low hematocrit and preoperative elevated serum blood glucose level. Regarding post-operative complications, there were significant higher frequencies of hematoma, dehiscence infection, and seroma in Group 1 compared with Group 2. Also there is significant difference between them as regard duration of postoperative hospital stay that was more in drain group. Conclusion: In gynecologic surgery, a subcutaneous negative pressure drain is a useful tool for managing wounds.