Introduction: Surgical antibiotic prophylaxis has become standard practice for patients undergoing colorectal surgery. This clinical practice has changed greatly over the last three decades, and it is currently accepted worldwide. It is phenomenal in minimizing postoperative wound infection in elective surgery. Clinical practice guidelines have been developed to herald this. However, the practice is yet to be established in some regions, particularly lowincome countries. A review of the evolution of the practice is necessary. Clinical Overview: Being a clean-contaminated procedure, colorectal surgery is a typical indication for antibiotic prophylaxis. The antibiotic for use is chosen on the basis of – its activity against endogenous flora likely to be encountered, its toxicity, and its cost, in that order.