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Objective: To assess the effect of implementation of World Health Organization (WHO) Surgical Safety Checklist (SSC) on patient outcomes in surgical cases in a tertiary care hospital of Delhi. Background: Use of the WHO Surgical Safety Checklist has been shown to be associated with significant reductions in peri-operative complications and deaths. Design: This study was conducted at a tertiary care hospital of Delhi on 152 major surgeries. Methods: In 80 cases (group I), this checklist was followed, while in 72 cases (group II), conventional practices were followed. In both the groups, the rates of perioperative complications and critical events were compared. Results: The complication rate was 15.27% for group II whereas it was only 5% in group I. Conclusion: Implementation of the checklist was associated with a greater than one-third reduction in peri-operative complications. [ABSTRACT FROM AUTHOR]