Abstract Objective Chronic postsurgical pain (CPSP) is defined as new and persisting pain three months after a surgical procedure, whereby other causes of pain have been excluded. Although CPSP following orthopedic or gynecological surgery has been well investigated, we are lacking data for patients undergoing abdominal visceral surgery. We aim to identify the risk factors for CPSP in this patient population. Methods We performed a retrospective case-control matched analysis including all patients diagnosed with CPSP after abdominal visceral surgery between 2016 and 2019, matched to a control group of patients who did not develop CPSP. Excluded were patients for whom no follow-up was available 3 months or more after surgery. Two-to-one case-control matching was based on operation category (hepato-pancreatico-biliary, upper gastrointestinal, colorectal, transplantation, bariatric and others) and date of surgery. The influence of personal, surgical and pain management factors were explored and multivariate logistic regression analysis was performed. Results 176 patients were diagnosed with CPSP during the study period. They were matched to a sample of 394 control patients extracted from the cohort of 3554 patients without CPSP. The incidence proportion of CPSP was 4.7%. Multivariate logistic regression analysis showed that age under 65 years (OR 2.22, CI 1.34-3.69, p=0.002), preexisting chronic pain of any origin (OR 3.39, CI 2.04-5.62, p=0.000), previous abdominal surgery (OR 1.71, CI 1.07-2.71, p=0.024), acute postoperative pain (2.62, CI 1.55-4.42, p=0.000) and length of stay over three days (OR 2.11, CI 1.26-3.53, p=0.004) were independent risk factors for CPSP. Preoperative Pregabalin intake was protective (OR 0.04, CI 0.01-0.33, p=0.003). Conclusion The identification of these risk factors allows for a preventive and personalized health care approach to our at-risk patients, for whom the optimization of postoperative acute pain management and an additional follow-up consultation 3 months after surgery might be indicated to avoid a delay in diagnosing CPSP. A possible explanation for the protective effect of Pregabalin is that in these patients, preexisting chronic pain might be better controlled in the preoperative phase, and they might have additional follow-up in the postoperative phase, be it from a pain specialist or their general practitioner.