Purpose: Hypoalbuminemia, an indicator of protein-energy malnutrition, is associated with increased morbidity and mortality in acute surgical patients due to enhanced catabolism. This study aims to investigate the relationship between preoperative serum albumin levels and postoperative outcomes in patients undergoing open abdominal surgery. Methodology: A retrospective analysis was conducted using ORMIS (Operating Room Management Information System) and hospital coding to identify all laparotomy and open surgery cases from January 2021 to June 2023. Data collected included patient demographics, comorbidities, preoperative serum albumin, laboratory values, surgical category, postoperative complications, hospital length of stay, and 30-day mortality. Hypoalbuminemia was defined as serum albumin levels below 35 g/L. Results: A total of 182 patients were analyzed, with 101 classified as hypoalbuminemic (serum albumin <35 g/L) and 81 with normal albumin levels (≥35 g/L). The hypoalbuminemic group had significantly lower haemoglobin levels (126 g/L vs. 142 g/L, p<0.001) and higher ASA scores, with more patients classified as ASA 4 and 5 (33.7% and 12.9% vs. 14.8% and 9.9%, p=0.024). They experienced longer hospital stays (10 vs. 7 days, p=0.006), higher rates of wound dehiscence (11.9% vs. 2.5%, p=0.018), and increased mortality (11.9% vs. 3.7%, p=0.046). Conclusion: Preoperative serum albumin is an effective and cost-efficient predictor of surgical outcomes after open abdominal surgery. Its integration into routine preoperative assessments could improve patient management and risk stratification