OBJECTIVE The aim of the present study was to assess obesity as a risk of adverse outcomes following cardiac surgery. METHODS The data of 324 consecutive patients who underwent elective procedures requiring cardiopulmonary bypass in a single cardiac center in South-Western Anatolia were retrospectively analyzed. There were 250 males and 74 females. Median age was 58.8 years (range 17 to 90 years). A body mass index (BMI)> or =30 kg/m2 was defined as obesity. Adverse outcomes analyzed included in-hospital mortality, chest tube drainage, reopening, inotropic support, arrhythmias, deep sternal wound infection, superficial surgical site infection and hospital stay duration. Multiple logistic regression analysis was performed to assess the relationship of obesity with clinical outcomes after cardiac surgery. Covariates considered in the logistic model included age, gender, pulmonary disease, cerebrovascular disease, smoking, hypertension, and diabetes. RESULTS Fourteen percent of patients (47/324) were obese and this ratio is quite smaller than reported for industrialized countries. The results of multiple regression analysis demonstrated that obesity was a risk factor only for superficial sternal or harvesting site infection (odds ratio--4.5, 95% CI--1.404-14.679, p=0.012). CONCLUSION Obesity was associated with increased risk of superficial surgical wound infections following cardiac surgery. In comparison with industrialized countries, obesity may account for fewer adverse events in patients undergoing open-heart surgical procedures in South-Western Anatolia, a developing country sample.