Background: Obesity is a a nightmare for every surgeon who desires to avoid many complications and several risks in his practice , specifically for obstetricians , multiple adverse pregnancy outcomes affecting both mother and fetus present in obese mothers . This study aimed to compare between the efficacy of subcutaneous tissue re-approximation alone or in combination with subcutaneous drain insertion in obese women undergoing elective caesarean delivery operation.Methods:This study was conducted on 400 obese women undergoing elective cesarean section with BMI > 25; randomized to 'subcutaneous tissue re-approximation alone' (200 women) or 'subcutaneous tissue re-approximation in combination with subcutaneous drain' (200 women).All obese women undergoing caesarean delivery operation, with the following criteria were included: Body mass index (BMI)> 25. , Hemoglobin 10 gm/dl , Pfannenstiel incision , Elective caesarean delivery , Normal laboratory investigations (CBC, LFT, KFT and bleeding profile). This study was divided into two groups; group I included 200 patients who have subcutaneous tissue re-approximation alone, group II included 200 patients who have subcutaneous tissue re-approximation in combination with subcutaneous drain. Results:No significant differences were noted between both groups regarding age, BMI, diabetes, hypertension, heart disease, subcutaneous tissue thickness, pre- and post-operative hemoglobin and infection. But, hematoma and range of hospital stay were significantly higher in group II than group I. Also, Dehiscence and seroma were significantly higher in group I than group II.Conclusion: This study has shown that the additional use of subcutaneous drain along with a standard subcutaneous tissue re-approximation as prophylactic technique seem to be not effective for the prevention of wound complications in obese women undergoing caesarean section