Background: Surgical site infections (SSIs) are a significant and persistent challenge in surgical practice, particularly in emergency abdominal surgeries. The current study aimed to evaluate the incidence of surgical site infections (SSIs) in emergency abdominal surgeries, identify the associated bacterial pathogens, assess their antibiotic resistance patterns, and examine risk factors contributing to SSIs. Materials and Methods: This prospective study included 120 patients admitted to the surgical wards, divided into two groups: 60 undergoing emergency surgeries (Group A) and 60 undergoing planned surgeries (Group B). Preoperative and postoperative evaluations were conducted, and wound discharge samples were sent for culture and sensitivity testing. Data were analyzed using SPSS software, with statistical significance set at p < 0.05. Results: SSIs were significantly higher in the emergency group (30.00%) than in the planned group (6.67%). The highest SSI rates in the emergency group were observed in dirty (30.77%) and contaminated (25.00%) wounds, compared to 12.00% in clean-contaminated and 3.33% in clean wounds in the planned group. Diabetes, anemia, and smoking were notable risk factors, with rates of 30.00%, 33.33%, and 30.00%, respectively, in the emergency group. Escherichia coli (47.62%) and Staphylococcus aureus (38.09%) were the predominant organisms, with Amikacin and Metronidazole demonstrating high efficacy. Conclusion: Emergency abdominal surgeries had significantly higher SSI rates compared to planned surgeries, particularly in cases involving comorbidities, longer durations, and contaminated or dirty wounds. Optimized preoperative care, strict aseptic techniques, and targeted antibiotic therapy are essential to reduce SSI rates and improve outcomes.