This chapter’s main topics are the history, risk factors, classifications, microbiology, prevention, and treatment of sternal wound infections (SWIs), which offers a thorough review of wound care following heart surgery. It emphasizes the development of surgical methods and the 1957 introduction of the median sternotomy incision, followed by improvements in the treatment of infections and sternal abnormalities. The chapter lists several risk factors, such as patient-related, intraoperative, and postoperative factors, and talks about the high morbidity and mortality linked to SWIs, especially deep sternal wound infections (DSWIs). Antimicrobial prophylaxis, appropriate wound care management, and the application of cutting-edge treatments including platelet-rich plasma (PRP), negative pressure wound therapy (NPWT), and silver dressings are all emphasized. The role of radiologic examination in infection diagnosis is also included in the document. Antimicrobial prophylaxis, appropriate wound care management, and the application of cutting-edge treatments including platelet-rich plasma (PRP), negative pressure wound therapy (NPWT), and silver dressings are all emphasized. The relevance of radiologic examination in infection diagnosis and the multidisciplinary strategy necessary for successful treatment—including antibiotic medication, muscle flap restoration, and surgical debridement—are also included in the text. It also emphasizes how important it is to educate patients and their families on taking care of incisions to maximize healing and lower the chance of infection.