Background <p>Postoperative complications in hand surgery can be influenced by factors such as nutritional and metabolic factors. Understanding these associations is critical for improving surgical outcomes. The aim of this study was to investigate the impact of glycemic, renal, and thyroid markers, smoking, anthropometric measures, vitamin D, and albumin levels on postoperative complications in patients undergoing hand surgeries.</p> Methods <p>This cross-sectional study included patients who underwent hand surgery from 2018 to 2023. Demographic data, preoperative fasting blood sugar (FBS), glycated hemoglobin (A1C), thyroid-stimulating hormone (TSH), blood urea nitrogen (BUN)/Creatinine ratio, smoking status, body mass index (BMI), vitamin D and albumin levels, and postoperative complications were recorded. Multivariate logistic regression was used to identify predictors of complications.</p> Results <p>Multivariate analysis on 690 participants identified age (OR = 1.02), vitamin D sufficiency (OR = 0.57), smoking (OR = 1.81), albumin levels (OR= 0.35), FBS (OR = 1.03), and A1C (OR = 1.08) as significant predictors of complications. No significant association was observed between gender, BMI, BUN/Cr ratio, TSH levels, and complications.</p> Conclusion <p>Age, vitamin D sufficiency, smoking status, glycemic control, and albumin levels significantly influence postoperative complication risks. Optimizing these factors preoperatively may improve outcomes. Future studies should confirm these findings and explore targeted interventions.</p>