Background: Use of the latissimus dorsi flap has become a first line option in reconstruction of the breast cancer patient. Seroma is a commonly described post operative complication. Seroma becomes particularly significant when its prolonged presence delays further oncologic treatment. Objective: Our hypothesis was that incidence of postoperative seroma was directly attributable to whether axillary node dissection was done at the time of breast reconstruction. Methods: A retrospective chart review (1998-2003) of all patients undergoing latissimus dorsi breast reconstruction was performed (n=46). Age, timing of breast reconstruction, axillary vs sentinel node dissection and chemotherapy status were all examined. Results: Overall incidence of seroma formation was 41%. Those patients having axillary node dissection were found to have a higher incidence of seroma (46%) than those undergoing sentinel node dissection (33%)[p=.28]. Age was also significant with age > 50, 58% formed seroma as opposed to age < 50, 30% formed seroma [p=.05]. Conclusions: Presence of axillary node dissection as well as age over 50 years were predictors of seroma formation. Results of this study may provide insight to the breast care team when formulating a treatment plan for the patient who requires post surgical oncologic treatment.