Dissertation (MMed Obstetrics and Gynecology)Background Surgical site infection (SSI) is one of the common complications after cesarean section in Tanzania and other parts of the world. High rates of SSI have been reported in literature with demonstrable multiple drug resistance of the isolates. Identification of isolates and their susceptibility pattern is key to development of evidence-based treatment protocols and effective preventive strategies. Objectives: The aim of this study was to determine the bacterial etiology, antibiotics susceptibility pattern and treatment modality of SSI among post cesarean delivery women in Iringa region. Methods: This was a cross sectional study design, which enrolled 162 participants with SSI from 5 hospitals in Iringa region. Structured questionnaire was used to collect data on demographic characteristics. Wound discharge was collected for culture and sensitivity and sent to laboratory for processing and interpretation according to standard laboratory procedure. Definitive treatment plan in the patient’s file was considered as treatment modality. Data analysis was done using SPSS version 20. Frequency and percentage were used to present categorical variable. Bivariate analysis was done to determine the association. Confidence interval (CI) of 95% and Odd ratio (OR) were used to determine association and p value of< 0.05 was considered significant. Results: Out of 162 women with SSI enrolled in the study, 59.7% had superficial SSI and 35.2% had deep. 156(96.3%) were culture positive of which 83(53.2%) were gram positive, 58(37.2%) were gram negative, and 15(9.6%) were mixed. Prominent organism isolated was Staphylococcus aureus 65 (40.1%). Resistance of grampositive isolates to Vancomycin and chloramphenicol was 3.1% and 13.8%. Methicillin Resistant Staphylococci aureus (MRSA) was 64.6%. Majorities of patients (58%) were managed non-surgically. Patients with S.aureus isolates were 3.7 more likely to be managed surgically (OR 3.65, 95%CI 2.09-6.38, p =< 0.001). Conclusion: There is high rate of bacterial isolates among patient with surgical site infection at Iringa. The common organism isolated was Staphylococcus aureus with high rate of MRSA. There is demonstrable resistance to common prescribed antibiotics. Majority was treated by non-surgical modality. Staphylococcus aureus infection was associated with surgical intervention.