We retrospectively reviewed the medical records of our hospital between 1 March 2001 and 1 March 2003 for patients with episiotomy dehiscence. In the study period, there were 37 patients with episiotomy dehiscence. While 12 of the patients with episiotomy dehiscence were allowed to heal by secondary intention, 25 patients underwent early repair. All the episiotomies were mediolateral. Infection was the obvious cause of dehiscence in the majority (25 out of 37) of the women. The average time from recognition of dehiscence to discharge from hospital was 5.6 +/- 2.8 days for the patients with early repair of episiotomy dehiscence and 5.8 +/- 2.4 days in patients allowed to heal by secondary intention. Patients were seen 2 weeks after being discharged. Among the patients treated by early repair, three patients had a superficial separation of skin edges. Healing was complete in the rest of the patients with early repair of episiotomy dehiscence. We concluded that with adequate preoperative care, primarily wound cleansing and intravenous antibiotics, early repair of episiotomy dehiscence is safe and effective.