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To determine the incidence and clinical correlates of postoperative cardiac arrhythmias in patients undergoing elective large bowel resection.Fifty-one consecutive patients undergoing elective open colorectal resection were recruited for this prospective observational study. Participating patients underwent daily three-lead electrocardiograms postoperatively. Data regarding potential risk factors for arrhythmias were recorded. Post-operative complications were recorded.Thirteen (26%) patients developed a postoperative arrhythmia, most commonly atrial fibrillation. Significant univariate correlates with postoperative arrhythmias were: age (P < 0.01), hypertension (P < 0.01), pre-operative serum potassium levels (P < 0.01), postoperative pulmonary oedema (P = 0.03), postoperative serum potassium (P = 0.03) and sodium (P < 0.01). Arrhythmia patients were more likely to have other complications (P = 0.02). Thirty-one percent of arrhythmia patients had underlying sepsis compared with 18% of controls (P = 0.38).Arrhythmias are common following elective large bowel resection. They occur in older patients and are associated with the development of other complications.