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Alphonsine Imanishimwe,1,2 Celestin Banamwana,1 Georges Bucyibaruta,3,4 Christian Nsanzabaganwa,5 Faustin Ntirenganya,2,4 Erigene Rutayisire1 1School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; 2Global Surgery Research Hub Rwanda, University of Rwanda, Kigali, Rwanda; 3Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda; 4School of Medicine and Pharmacy, College of Medicine and Health Science, University of Rwanda, Kigali, Rwanda; 5Research, Innovation and Data Science Division (RIDS), Rwanda Biomedical Centre (RBC), Kigali, RwandaCorrespondence: Alphonsine Imanishimwe, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda, Email imanishimwealpha@gmail.comBackground:  Surgical site infections (SSIs) remain a major cause of postoperative morbidity and mortality, particularly following abdominal surgeries. Environmental factors are key contributors, yet evidence from East Africa remains fragmented. This scoping review mapped available evidence on environmental determinants of SSIs in abdominal surgeries across East African healthcare settings to inform context-specific interventions.Methods: Following the Arksey and O’Malley framework, a comprehensive search of PubMed, Embase, CINAHL, and African Journals Online identified studies published between 2014 and 2024. Eligible studies included quantitative, qualitative, and mixed-method research addressing environmental factors associated with SSIs in abdominal surgeries. Data were thematically analyzed, with findings from Rwanda compared to Uganda, Tanzania, Kenya, and Burundi.Results: Nineteen studies met inclusion criteria (nine cross-sectional, six cohort, one chart review, one quality improvement, one mixed-method, and one surveillance study). Few studies directly examined temperature, ventilation, and humidity, though their influence was indirectly recognized. Poorly implemented cleaning protocols, absence of standardized infection prevention and control (IPC) guidelines, and inadequate IPC training were major contributors to high SSI rates. Rwanda showed weaker SSI surveillance compared to Kenya and Uganda. Klebsiella spp. E. coli, and Staphylococcus aureus were the predominant pathogens, exhibiting high antibiotic resistance. Additionally, inadequate staffing, poor infrastructure, and contamination in operating theaters and wards elevated SSI risk across the region.Conclusion: Environmental factors substantially influence SSI burden in East Africa. Strengthening IPC training, environmental controls, and surveillance, alongside developing affordable, context-specific interventions, is vital to reduce SSIs and improve surgical outcomes.Keywords: surgical site infections, abdominal surgery, environmental factors, temperature control, ventilation, hospital cleaning, Rwanda, infection prevention