Background: Detection of methicillin-resistant Staphylococcus aureus (MRSA) carriers on admission for surgery is an important component for controlling the spread of MRSA and contributes to the reduction of SSI. Objective: To identify the prevalence of MRSA nasal colonization among patients admitted to the surgery department and factors associated with it as well as to investigate the impact of decolonization of MRSA nasal carriers on the surgical site infection rate in addition to identification o risk factors for SSIs. Design and Methods: A prospective study was conducted in 2 surgical units in Kasr El-Aini hospital for 6 months, divided into 2 groups [a non-intervention group (n=240 patients) and an intervention group (n=274 patients)]. Patients admitted for surgery (n=514) were screened for MRSA nasal carriage. Positive MRSA carriers belonging to the intervention group were decolonized using intranasal application of sodium fusidate 2% ointment. Meanwhile SSI surveillance was performed to detect the SSI rate. Results: MRSA nasal carriers represented 11.3% of the admitted patients. Factors associated with MRSA nasal carriage included diabetes mellitus, anaemia, hypoalbuminaemia, emergency admission and contact with high risk hospital areas. The SSI infection rate in the non-intervention group of patients was 12.1%. This was reduced, but not significantly, to 8.9% in the intervention group. However, SSI among MRSA nasal carriers was reduced from 25% in the non-intervention group to 12.5% in the intervention group. Risk factors for SSI on multivariate analysis using logistic regression model included contaminated wound class, operative time longer than 2.5 hours and obesity. Recommendations: Targeted screening of patients, admitted for surgery, for MRSA nasal colonization and subsequent decolonization of positives would contribute to the reduction of SSI particularly among those carriers. Identifiable risk factors for SSI could be incorporated to formulate an index predictive for SSIs which would contribute for implementation of preventive measures for SSIs.