A prospective randomized study compared amoxicillin-clavulanic acid with cefazolin as prophylaxis in laparotomic gynecologic surgery. The results showed that febrile morbidity was relatively lesser in the amoxicillin-clavulanic acid group than in the cefazolin group. Moreover, wound infection and urinary tract infection were higher in the cefazolin group. One respiratory tract infection was also reported in the cefazolin group. Thus, it can be suggested that prophylaxis with amoxicillin-clavulanic acid displays a comparatively better safety profile than cefazolin and thus may help in obtaining favorable outcomes in elective laparotomic gynecologic surgery.