OBJECTIVES: Explore adhesion related complications (ARC) within one year after colon resection procedures, including occurrence, time to event, risk factors, and healthcare utilization for inpatient hospitalizations. METHODS: Using Truven MarketScan® Commercial and Medicare databases, all inpatient colon resections between 2009-2013 (INDEX): RIGHT (cecectomy/hemicolectomy), LEFT (hemicolectomy/sigmoidectomy), transverse, partial, or total were identified. One year continuous enrollment was required before (PRE-INDEX) and after (POST-INDEX). ARC was defined as the first hospitalization with a diagnosis of ileus or small bowel obstruction or an adhesiolysis procedure occurring POST-INDEX. Only the patient’s first ARC readmission was evaluated descriptively for total hospitalization cost (2015-USD), length of stay (LOS), and time to ARC. Patient, provider, and procedure factors associated with ARCs were explored in a multivariable model, p-values <0.05 were considered significant. RESULTS: A total of 64,532 colon resections were identified: LEFT=39.2%, RIGHT=34.9%, partial=20.0%, total=3.6%, and transverse=2.3%. Procedural approach was open (60.1%) and laparoscopic (39.9%). All cause inpatient readmissions within 1-year was 24.4% (N=15,755). ARC occurred in 5.7% (95%CI[5.6-5.9%]) of patients, accounting for 23.5%(N=3,705) of all inpatient readmissions within 1-year of INDEX. Mean time to ARC event was 130 days (SD=102) with mean LOS of 7.2 days (SD=8.0) and mean total cost of $29,802 (SD=$43,037) per hospitalization. Risk factors for ARC within 1-year included: adhesiolysis at INDEX (OR 2.46,[1.42-4.26]), resection type: total vs RIGHT (OR 3.78,[3.27-4.37]), CT imaging at INDEX (OR 1.80,[1.65-1.96]), surgical indication: inflammatory bowel disease vs cancer (OR 1.97,[1.63-2.37]), or multiple abdominal procedures at INDEX (OR 1.37,[1.27-1.47]). Laparoscopic approach at INDEX was protective compared to open surgery (OR 0.43,[0.39-0.46]). CONCLUSIONS: Adhesion related complications occurred in 5.7% of all patients within the first year after colon resection and have a substantial economic burden. Multiple patient and procedural characteristics increase the risk of these complications. Colon resections performed laparoscopically were associated with reduced adhesion related complications compared to open surgery.