Aim: To estimate the incidence, and to describe of antimicrobial resistance in responsible pathogens, and risk factors for surgical site infection (SSI) after abdominal surgery in Ukraine. Materials and Methods: This were a multicenter, prospective cohort study performed in ten tertiary care hospitals from different regions of Ukraine. Definitions of SSIs after abdominal surgery were adapted from the European Centre for Disease Prevention and Control Surveillance of SSI. The incidence of SSI and predisposing risk factors were noted. Results: Among 6,740 patients, 1,110 (16.5%) SSIs after abdominal surgery were observed. Of these cases, 45.8% superficial SSIs, 37.3% deep SSIs, and 16.9% was as organ/space SSIs. Of all SSI cases, 29.9% were detected after hospital discharge. The independent predictors of SSI were open surgical approach, emergency operation, and longed operation duration. The main pathogens of SSI were Escherichia coli (52%), followed by Staphylococcus aureus (9.1%), Enterococcus spp. (7.3%), Pseudomonas aeruginosa (7.1%), Acinetobacter baumannii (6.3%), Stenotrophomonas maltophilia (5.7%), Serratia marcescens (5.3%), and Klebsiella pneumoniae (5.1%). Meticillin resistance S. aureus (MRSA) and vancomycin resistance Enterococcus spp. (VRE) was found in 21.3% and 14.8% isolates, respectively. Conclusions: This study found a high prevalence of SSI after abdominal surgery caused by multidrug-resistant organisms, varying widely depending on the bacterial species, and antimicrobial group in Ukraine. To minimise the risk of complications after abdominal surgery, it is essential to take several preventive measures before, during, and after the surgery.