Introduction: Peritonitis is one of the commonest causes of acute abdomen in Ethiopia withrnhigh mortality and morbidity. One of the causes of high morbidity and mortality is persistentrnintraabdominal infection. Persistent intraabdominal infection is usually managed byrnrelaparotomy in our setup. The two essential approaches for managing post op collection arernRL on-demand (â€œwait and seeâ€ approach) and planned RL. Despite multiple studies, both haverncomparative mortality. These makes management of persistent intraabdominal infectionrnchallenging. This study aimed to identify Preoperative and intra operative clinical variables thatrnare predictive of persistent intraabdominal infection.rnObjectives: The aim of this study is to identify preoperative and intraoperative clinical factorsrnthat may predict the need for relaparotomy in patients with complex intra-abdominal sepsis, inrnorder to assist clinicians to decide timely intervention.rnMethods: A retrospective cross-sectional study was conducted on 172 cases of patients whornwere operated from Sept, 2018 to April , 2020 at two affiliated referral hospital of AAU, collagernof Medicine, Addis Ababa; Yekatit 12 referral hospital and Minilik II referral Hospital. All ofrnpatients were cases of secondary peritonitis. Clinical progress of the patients from admission torndischarge/death was documented. More than 20 preoperatve and intraoperative variablesrnwere analyzed to identify predictive model using logistic regression analysis.rnResults: Out of 172 patients with peritonitis included in this study, 70.9% were males. ThernMedian age group of patients was 25 yrs. 82% of patients were referred from Addis Ababarn(within the city). The median length of time from the onset of symptoms to seeking medicalrncare was 3 days. The most common cause of secondary peritonitis was complicatedrnappendicitis (52.9%), followed by perforated PUD (33.1%). Out of 172 laparotomy cases forrnsecondary peritonitis, 40 (23.3%) required relaparotomy for postop collection. From Patientsrnwho developed postop collection, 45% of them were diagnosed after pus/Gi content leakedrnthrough the surgical wound. In Our study, the mortality rate of patients who develop postoprncollection and undergone relaparotomy was 27.5 % and 4.5% for those without postoprncollection. Logistic regression identified the following 4 variables as having strong predictivernvalue: Duration of illness more than 5 days, Systolic BP 1000 ml and small bowel as source of contaminationrnConclusion: Management of persistent intra-abdominal infection is challenging. Sign andrnsymptoms of persistent intra-abdominal infection are subtle, resulting late diagnosis after onsetrnof MODS. Delay in diagnosis results in high mortality and morbidity. We have identified 4rnpreoperative and intraoperative variables available at first laparotomy to predict persistantrnintraabdominal infection requiring relaparotomy. These sets of variables can be a mile stone forrnfuture validation study before inserted into day to day clinical practice