AbstractBackground: Hypoalbuminemia is prevalent in patients undergoing major abdominal surgeries and is associated with adverse postoperative outcomes, including prolonged hospital stays, higher infection rates, and increased mortality. The clinical impact of albumin supplementation in these patients remains under scrutiny. Objective: This study evaluates whether albumin supplementation in hypoalbuminemic patients (≤3.0 g/dL) improves postoperative outcomes. Methods: This retrospective study included patients who underwent major abdominal surgery between January 2021 and December 2024 at a tertiary care hospital. Patients with hypoalbuminemia were divided into two cohorts of 250 each: those who received postoperative albumin supplementation and those who did not. Outcomes measured included length of hospital stay (LOS), infection rates, ICU admission rates, and 30-day mortality Results: The albumin supplementation group had a significantly shorter LOS (8.1 vs. 11.4 days, p < 0.001) and lower infection rates (10% vs. 17%, p = 0.02). There was no statistically significant difference in ICU admissions or 30-day mortality between the two groups (p = 0.58 and p = 0.19, respectively). Multivariate regression identified albumin supplementation as an independent predictor of reduced LOS and infection rates. Conclusion: Albumin supplementation in hypoalbuminemic patients post-major abdominal surgery improves recovery metrics by reducing LOS and infection rates without influencing short-term mortality. Future randomized controlled trials are necessary to validate these findings.