Objectives <p>Enhanced Recovery After Surgery (ERAS) is a multidisciplinary, evidence-based protocol designed to improve perioperative outcomes across various surgical specialties. While widely adopted in many surgical disciplines, its structured implementation in Obstetrics and Gynecology remains limited in several centers. This study was conducted to evaluate adherence to ERAS components in the Department of Obstetrics and Gynecology at a tertiary care hospital in South India, in the absence of a formal ERAS program.</p> Materials and Methods <p>This retrospective audit analyzed the records of patients who underwent elective gynecological surgery at a tertiary care center in India. Emergency surgeries and those performed with palliative intent were excluded. Adherence to ERAS elements, categorized into preoperative, intraoperative, and postoperative phases, was assessed as a measure of compliance with evidence-based perioperative care.</p> Results <p>The study included 69 patients. High compliance was observed in areas such as anemia correction, antibiotic prophylaxis, use of chlorhexidine baths, thromboprophylaxis, and timely ambulation. However, poor adherence was noted in components like prehabilitation, appropriate preoperative fasting, carbohydrate loading, gum chewing, coffee consumption, and early initiation of feeding in the postoperative phase.</p> Conclusion <p>This audit revealed good adherence to several ERAS principles, particularly in the preoperative and intraoperative phases. However, improvements are needed in nutritional and functional recovery components during the postoperative period. The establishment of a structured, multidisciplinary ERAS program is crucial for consistent implementation and better surgical outcomes.</p>