AbstractBackground: Surgical site infections (SSIs) represent one of the most significantcomplications following gastrointestinal (GI) surgery, contributing to prolongedhospitalization, increased morbidity and mortality, and substantial healthcare costs [1]. Whilestatins are primarily prescribed for cardiovascular risk reduction, their pleiotropic effects—including anti-inflammatory, immunomodulatory, and antioxidant properties—may influencepostoperative infection risk [2]. However, statins also lower serum cholesterol levels, andhypocholesterolemia has been independently associated with impaired immune function and increased SSI risk [3]. The interplay between statin-induced cholesterol lowering and statin-mediated immunomodulation in the context of GI surgery remains poorly characterized. Objective: The primary aim of this prospective cohort study was to evaluate the associationbetween preoperative statin use, resulting serum cholesterol levels, and the incidence ofsurgical site infections in patients undergoing elective gastrointestinal surgeries. Secondaryobjectives included assessing whether the protective immunomodulatory effects of statinsoutweigh the potential infection risk conferred by statin-induced hypocholesterolemia.