INTRODUCTION: Surgical site infection (SSI) represents 31% of all in-hospital-acquired disease, being the most common nosocomial infection. Represent the most serious complication in ankle and foot surgeries and presenting an incidence ranging from 0.5 to 6.5%. However, its consequences can be serious, such as infected pseudarthrosis, early arthrosis, amputation and death. Risk factors associated a SSI include: diabetes, advanced age, smoking, obesity, American Society of Anesthesiologists (ASA), prolonged preoperative hospitalization and remote infection in time of surgery. The aim of this study was to determine the incidence of SSI in clean ankle and foot surgeries in a private quaternary hospital. In addition, to identify the predictor variables that impact the occurrence of infection and the most prevalent microorganisms. MATERIALS AND METHODS: This was a 7 years retrospective cohort analytical study, with the analysis of data from electronic medical records of patients with ISS in clean surgeries of the ankle and foot. All medical records of patients aged ≥18 years who underwent elective and urgent ankle and/or foot surgery in the period from January 1, 2014 to 31 December 2020. Exclusion criteria were: patients with wounds or limbs with signs of infection, open fracture, septic arthritis, and surgical procedures such as debridement or amputations in diabetic feet. Variables The variables analyzed for the occurrence of infection were: age; sex; comorbidities such as arterial hypertension (AH) and diabetes mellitus (DM), elective or emergency surgeries, classification of surgical risk ASA, smoking, and body mass index (BMI). RESULTS: The foot and ankle team performed 3,139 surgical procedures, with 2,180 surgeries that met the inclusion criteria being included in the final sample. It was identified that 90.1% were under 65 years of age and 51,9% of the cases were male. The incidence of superficial infections was 2.8% and 1.2% of deep infections. Of the total sample, 24.8% had AH and 6.9% DM. The surgeries were elective in 51.4% of patients and almost half of the surgeries were classified as ASA I (49.7%). Only 5.7% were smokers and overweight and obese patients accounted for 45.1% and 21.1% of cases, respectively. Among the patients who developed deep infection, they had higher proportions of smokers (p=0.002), AH (p=0.018), emergency surgery (p=0.049) and ASA III or IV (p=0.011). Were associated with an increased chance of having an infection (superficial or deep), being a smoker (OR 2.8 95% CI 1.4-5.2, and ASA III or IV (OR 3.0, CI 95 % 1.1-6.9). The most prevalent bacteria were Staphylococcus aureus in 61.5%, followed by Pseudomonas aeruginosa in 15.4%. CONCLUSION: The overall incidence of infection was 4% and some factors related to increased risk of infection were identified, such as patients undergoing urgent surgical procedure, smoking, hypertension and ASA classification >2 and the development of deep infection.