Purpose: To evaluate the effect of prophylactic 4% chlorhexidine gluconate (CHG) wash on surgical site infection (SSI) rates in elective neurosurgical patients. Methodology: A retrospective quality improvement audit was conducted at Sir Charles Gairdner Hospital, Perth. Elective neurosurgical cases from March - October 2024 were reviewed, comparing pre-intervention (25/03/23–02/07/24) and post-intervention (03/07/24–04/10/24) periods. Two hundred cases were included per cycle. Adults aged 18–80 undergoing elective surgery were included; infective, trauma, and incomplete cases were excluded. The primary outcome was 30-day SSI rate. Proportions were compared descriptively. The audit standard was an SSI rate <5%. Results: Preliminary analysis included 50 patients (20 pre-intervention, 30 post-intervention). Mean age was 49.7 years (range 27-72) pre-intervention and 54.0 years (range 18–75) post-intervention. Smoking prevalence increased from 15% to 36.7%, while obesity prevalence remained 30% in both groups. Median ASA class was II in both cohorts. All patients in both cohorts received antibiotic prophylaxis at the time of surgery. CHG was administered to 1/20 patients pre-intervention and 19/30 post-intervention (17 pre-operatively, 3 post-operatively, including 1 both). Three patients required unplanned return to theatre pre-intervention compared with 0 post-intervention. One SSI occurred in the pre-intervention group (5%), with no SSIs identified post-intervention (0%). The infected case followed an elective, clean right titanium cranioplasty and grew Staph. aureus and Staph. epidermidis at 14 days postop. This patient did not receive chlorhexidine and was a smoker. Conclusion: Early results demonstrate that a standardised peri-operative chlorhexidine wash protocol was associated with elimination of early SSIs in this cohort. Final results will determine the sustainability and wider applicability of this low-cost, scalable safety intervention in neurosurgery.