BackgroundSurgical site infection (SSI) prevalence is higher in low and middle-income countries (LMICs) than in high-income counterparts. This study covers 116 INICC member hospitals in 75 cities across 25 Latin American, Asian, Eastern European, and Middle Eastern countries, including Argentina, Bahrain, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Egypt, Honduras, India, Kosovo, Kuwait, Lebanon, Mexico, Mongolia, Pakistan, Papua New Guinea, Philippines, Poland, Romania, Saudi Arabia, Thailand, Turkey, Venezuela, and Vietnam. MethodsProspective cohort multinational surveillance data were collected through the INICC Surveillance Online System. CDC-NHSN definitions were applied for surgical site infections (SSI). Surgical procedures were categorized into 41 types according to the ICD-9 criteria, 9th edition. ResultsFrom 2014 to 2023, we collected data on 1,251 SSIs associated with 56,617 SPs. SSI rates were significantly higher in SPs of INICC compared to CDC-NSHN data, including hip prosthesis (3.68% vs. 0.67%, RR=5.46, 95%CI=3.71-8.03, p<0.0001), knee prosthesis (2.02% vs. 0.58%, RR=3.49, 95%CI=1.87-6.49, p<0.0001), coronary artery bypass graft (4.16% vs. 1.37%, RR=3.03, 95%CI=2.35-3.91, p<0.0001, peripheral vascular bypass (15.69% vs. 2.93%, RR=5.35, 95%CI=2.30-12.48, p<0.0001), abdominal aortic aneurysm repair (8.51% vs. 2.12%, RR=4.02, 95%CI=2.11-7.65, p<0.0001), spinal fusion (6.47% vs. 0.70%, RR=9.27, 95%CI=6.21-13.84, p<0.0001), and laminectomy (2.68% vs. 0.72%, RR=3.75, 95%CI=2.36-5.95, p<0.0001), among others. ConclusionsElevated SSI rates in LMICs emphasize the need for effective interventions to alleviate this substantial burden.