Introduction: Surgical site infections (SSI) are among the most serious complications in women undergoing cesarean section. Surveillance plays a crucial role in infection prevention. In this perspective, our institution has committed to establishing an epidemiological surveillance system in the maternity Service. The main objective of our study is to analyze the evolution of surgical site infections (SSI) in the maternity Service from 2014 to 2020. Secondary objectives include evaluating the practice of antibiotic prophylaxis prescription and identifying risk factors and pathogens involved. Materials and Methods: This is a descriptive cohort study with analytical purposes carried out between 2014 and 2020. The recruitment of parturient took place between February and April of each year with the establishment of a “care-bundle” for the prevention of SSI after the first year of monitoring. Data collection was done in real time (daily) with follow-up until D30 on a pre-established questionnaire, pre-, per- and post-operative, it included variables concerning the identification of the patient, the ASA score, the score NNIS, data on antibiotic prophylaxis and SSI characteristics. The diagnosis of SSI was established according to the Atlanta CDC criteria. Data entry and analysis were carried out using Epi-info6 software. Results: A total of 1368 (1165+203) cesarean sections were performed during the study period. The mean age of the parturient was 33.6 years± 6.7. 81.94% (1121/1368) had an ASA score of 1, and 73.5% (1006/1368) had a NNIS score of zero. 88.5% (1031/1165) were Altimeter class II. A total of 118 SSIs were diagnosed and treated, resulting in a cumulative incidence rate of 8.6% (118/1368), of which 83% (98/118) were superficial infections. The highest rate of nosocomial infections (NI) was recorded in 2014, reaching 16.7%. This rate experienced a significant decrease in 2015 to a rate of 4.6% after the implementation of a "care bundle," including training of the healthcare team on infectious risks and standardization of some care procedures. However, we observed an increase in the rate in 2019, reaching 13.04%, following a surveillance interruption in 2018 caused by a strike of resident physicians lasting over six months. Subsequently, the rate decreased again in 2020, coinciding with the implementation of standard precautions during the COVID-19 pandemic. Regarding antibiotic prophylaxis, we noted non-compliance in the choice of molecule (the use of C3G was observed in 85.6% of cases), as well as in its duration, where antibiotic administration was prolonged for the entire duration of hospitalization. We identified five significant risk factors: ASA score > 2 (ORa=3.7, 95% CI [1.8-7.6], p<0.001), premature rupture of membranes exceeding 12 hours before hospitalization (ORa=5.6, 95% CI: [2.4; 13.2], p<0.001), Altimeter class ≥ 3 (ORa=9.9, 95% CI: [4.6-21.2], p<0.001), presence of more than 5 individuals in the operating room (ORa of 3.5, 95% CI [1.3-9.1], p<0.001), and hyperthermia (OR=1.42, 95% CI [1.03; 3.36], p<0.04). Staphylococcus aureus represents 45.45% of isolated organisms (including MRSA), and Gram-negative bacilli were identified in 40% of cases, with 21.42% being extended-spectrum beta-lactamase (ESBL) producing strains. Conclusion: Prevention of nosocomial infections primarily focuses on preventing avoidable infections. Surveillance of nosocomial infections (NI) and implementation of corrective measures have led to a decrease in the incidence rate. It is crucial to continue these modifications in the work system to maintain these rates.