Background:Malnutrition presents a significant challenge for individuals residing in long-term care facilities, and it remains a concern for patients entering hospitals, many of whom may already be malnourished or susceptible to malnutrition. This study seeks to assess how major elective orthopaedic surgery impacts the nutritional status of patients within a recently established tertiary care center.Methods:This prospective study involved 100 patients admitted and undergoing orthopaedic procedures within the Department of Orthopaedics over a one-year period. Nutritional assessments were conducted utilizing both anthropometric measurements (BMI) and biochemical markers (Pre-albumin and Transferrin). Evaluations were performed at three key time points: preoperative, postoperative (at suture removal), and during a three-month follow-up. A comprehensive proforma was completed for each patient, capturing essential information such as demographics, diagnosis, surgical procedures, existing comorbidities, and nutritional parameters.Results:Throughout the one-year duration, a total of 100 patients were assessed, with 62 cases (62% follow-up) being actively monitored. Notably, the pre-albumin and transferrin values at various stages (preoperative, postoperative, and follow-up) exhibited significant differences among patients with humerus shaft fractures and tibia shaft fractures. Additionally, when comparing mean pre-albumin values between the humerus shaft fracture and lower limb surgery groups, a statistically significant difference was observed (p<0.05**).Conclusion:Our findings lead us to conclude that pre-albumin proves to be a dependable nutritional marker. It can be employed as a routine assessment tool for patients identified as at risk of malnutrition. This proactive use of pre-albumin allows for timely nutritional interventions, aiming to prevent potential complications associated with malnutrition.