Clostridium difficile is a major cause of hospital-acquired infections. Attention has been focused over the past 2 decades to the increasing incidence of C difficile infection (CDI), the high recurrence rates, and the associated morbidity and mortality. Patients undergoing surgical procedures are at relatively high risk for the development of CDI secondary to environmental exposures, perioperative antibiotic use, altered enteral intake, postoperative ileus, and frequent use of proton pump inhibitors or H2 blockers.