OBJECTIVE: Smoking is associated with increased severity and recurrence of Crohn's disease (CD), but its impact on perioperative outcomes is unclear. This study evaluated the association between smoking and 90-day postoperative complications in patients with CD undergoing abdominal surgery. METHODS: We conducted a retrospective cohort study (2017-2019) of 294 patients with CD who underwent abdominal surgery. Patients were categorized as current smokers versus past/never smokers. Outcomes included 90-day complications, severe complications (Clavien-Dindo >/=3), and length of stay (LOS). Multivariable regression was performed to adjust for confounders. RESULTS: Current smokers (n ​= ​79, 26.8 ​%) had higher rates of overall (64.6 ​% vs. 43.7 ​%, p ​= ​0.002) and severe complications (19 ​% vs. 6.5 ​%, p ​= ​0.001). Smoking was independently associated with overall complications (OR ​= ​2.17), severe complications (OR ​= ​3.20), and prolonged LOS (beta ​= ​3.01 days, p ​= ​0.002). Past smokers had outcomes similar to never smokers. CONCLUSION: Current smoking is independently associated with increased complications and longer hospitalization following CD surgery.