Abstract Introduction: Modified radical mastectomy (MRM) remains a standard surgical procedure for operable breast carcinoma. The use of postoperative drains has traditionally been recommended to reduce seroma formation and other wound-related complications. However, recent evidence questions the necessity of routine drainage. This study evaluates outcomes of drain versus no-drain policy in MRM.Materials and Methods:A prospective comparative study was conducted among 120 patients undergoing MRM for carcinoma breast. Patients were randomly divided into two groups: Drain group (n=60) and No-drain group (n=60). Primary outcomes included seroma formation, wound infection, flap necrosis, hematoma, duration of hospital stay, and need for intervention. Statistical analysis was performed using Chi-square and independent t-test.Results:Seroma formation was higher in the no-drain group (30%) compared to the drain group (15%) (p<0.05). However, duration of hospital stay was significantly shorter in the no-drain group (3.2±0.8 days vs 6.5±1.1 days). No significant difference was observed in wound infection, flap necrosis, or hematoma rates.Conclusion:The no-drain policy is associated with shorter hospital stay without significant increase in major complications, though seroma incidence is moderately higher. Selective drain use may be considered.