Tetanus, which occurs usually as a complication of minor trauma, has also been reported following elective and emergency surgical procedures, particularly those involving the gastrointestinal tract. Early diagnosis of tetanus in the postoperative period is difficult, requiring a high index of suspicion. The possibility of tetanus should be considered in any nonimmunized postoperative patient who develops crampy abdominal pain, fever, and abdominal wall rigidity. Adequate tetanus immunoprophylaxis is essential for all patients undergoing gastrointestinal surgery.