The rate of surgical site infection and the frequency of various pathogens causing surgical site infection with their antibiotic resistance pattern in general surgery unites were studied in the period of six months from April 2010 to September 2010.A total of eight hundreds and eighty one patients admitted for surgery (clean, clean - contaminated and contaminated cases) were assessed preoperatively, intraoperatively and postoperatively.Patients were followed up for 30 days post-operatively. Swabs were taken from wounds suspected to be infected and studied clinically and were subjected to culture . The overall wound infection rate was 9.3%. Surgical site infection rate was 7.9 % in clean surgeries , 12.7 % in clean-contaminated surgeries and 11.3% in contaminated surgeries .Significant increase in surgical site infection rate occurred with using combination preoperative prophylactic antibiotic therapy rather than when using one antibiotic as preoperative prophylaxis. The increase in the duration of surgery also was associated with a significant rise in the rate of surgical site infection.Surgical site infection rate was significantly higher (4.9 %) in cases where a drain was used than in non drained wounds (4.4%) (P-value <0.001) .The most common isolates were Staphylococci aureus 24.3% followed by Klebsiella 18.5 %, E.coli 17.5 % and Pseudomonas Spp. 14.6 %.The most common resistance pattern among gram negative isolates were ESBL (27.1 %), MDR (16.5 %) and AmpC (0.9%) and among gram positive isolates MRSA constitutes (16.5%) and MLS (0.9%).The overall consumption profile of antibiotics demonstrated that 3rd generation cephalosporines were widely used by 70% of postoperative patients, Amikacin was used by 9% Imipenem by 7%, Tienam by 4% and lastly 10% of postoperative patients were given other classes of antibiotic as a postoperative empiric prophylactic antibiotic therapy.In conclusion; The most significant factors for SSI were operative time and the use of the drain and the underlying disease such especially diabetes mellitus The emergence of resistant and multidrug resistant strains is directly related to the heavy use of antibiotics especially inappropriate ones.Our study aims to assess in vitro activity of such antibiotics in comparison to the pattern of resistance of different microbial pathogens that cause surgical wound infection. It also aims to study different guidelines of preoperative prophylactic antibiotics as well, in order to find out the most effective regimen for prevention and prophylaxis against the increasing frequency of polymicrobial infections with subsequent improvement the quality of health care system and decrease in the cost and economic burden of the hospital stay by postoperative patient.Adherence to guidelines for surgical prophylaxis must be improved. To achieve optimal adherence, antibiotic policy makers should develop evidence-based guidelines in collaboration with surgeons, guarantee an effective distribution of guidelines and perform periodic cross-sectional analyses about their adoption in wards and also between hospitals.The causative microorganisms infecting the surgical wound and their resistance profile should be well studied to be properly treated according to the results of culture and sensitivity testing , so that decreasing the emergence of the resistant and multidrug resistant stains with subsequent decrease in the cost of hospital stay.