Background: Burst Abdomen is a preventable condition in which many risk factors play their role and lead to life threatening complications. The aim of the present study is to identify the different risk factors and high risk patients for burst abdomen for decreasing the rate of burst abdomen post operatively. Patients and methods: An observational analytical study included 110 patients and carried out in General Surgery Department, Faculty of Medicine, Zagazig University Hospitals. The patients were divided into 2 main groups: post-midline laparotomy burst abdomen patients and postmidline non complicated laparotomy with burst abdomen patients. Evaluation of different risk factors between the two groups was performed. Results: There is statistically significant relation between occurrence of burst abdomen and both smoking and obesity. There is statistically significant relation between occurrence of burst abdomen and all of direct trauma, diabetes, intraabdominal infection and jaundice. There is non-significant relation between occurrence of burst abdomen and other risk factors. There is statistically significant relation between occurrence of burst abdomen and postoperative ileus, pulmonary complications and wound infection. Diabetes, wound infection, smoking and direct trauma increased risk of burst abdomen by 47.205, 58.547, 40.559 and 39.874 folds respectively. Conclusion: Intra-abdominal infection is the most important factor in predicting burst abdomen. Patient factors like anemia, diabetes, smoking, peritonitis due to bowel perforation act as determinant for wound dehiscence. Postoperatively abdominal burst can be prevented by improving the nutritional status of the patient, early mobilization of the patient and simple investigations like Hemogram, RBS, RFT, LFT, chest x-ray may help to detect predisposing factors.