Introduction: Surgical site infections (SSIs) often manifest after patients are discharged and are missed by hospital-based surveillance. Methods: We conducted a case-reference study nested in a prospective cohort of patients from six surgical specialties in a teaching hospital. The factors related to SSI were compared for cases identifi ed during the hospital stay and after discharge. Results: Among 3,427 patients, 222 (6.4%) acquired an SSI. In 138 of these patients, the onset of the SSI occurred after discharge. Neurological surgery and the use of steroids were independently associated with a greater likelihood of SSI diagnosis during the hospital stay. Conclusions: Our results support the idea of a specialty-based strategy for post-discharge SSI surveillance.