To explore the effect of hydroxybutyl chitosan on the prevention of postoperative peritoneal adhesion in rats. Methods Ninety SD rats (half males and half females) weighing 250-280 g underwent laparotomy with subsequent cecal wall abrasion and peritoneal adhesion. Rats were randomized into 3 groups (n=30 per group): group A, injection of 2 mL hydroxybutyl chitosan solution (2%); group B, injection of 2 mL sodium hyaluronate solution(2%); group C, the abdomen of rat was exposed for 30 seconds and served as control group. The general condition of the rats was observed after operation. The rats were killed 2 and 4 weeks after operation, 15 rats per group at a time, to undergo gross and histologyobservation. The degree of adhesion was evaluated by double-bl ind method. The microstructure of injured electroscope cecal wall in groups A and C was observed with transmission electroscope 4 weeks after operation. Results All rats survived till the end of experiment. At 2 weeks after operation, the adhesion and the hyperplasia of fibrous connective tissue and collagen in groups A and B were sl ight while the adhesion in group C was serious with severe hyperplasia of fibrous connective tissue. According to the measurement classification by Nair histological grading, the difference between groups A and B and group C was significant (P lt; 0.05), while no significant difference was evident between group A and group B (P gt; 0.05). At 4 weeks after operation, the adhesion in group A was mild, and the hyperplasia of fibrous connective tissue and collagen were sl ight; the adhesion and the hyperplasia of fibrous connective tissue and collagen in group C were serious. The levels of group B were between group A and group C. The differences among three groups were significant (P lt; 0.05). Transmission electroscope showed inactive fibroblasts and loose thin collagen fibers in group A, and active fibroblasts and closely collagen fibers arranged in a disorderly manner in group C. Conclusion Hydroxybutyl chitosan can decrease the hyperplasia of fibrous connective tissue and inhibit the activity of fibroblasts significantly, and has a long-term role of preventing peritoneal adhesion.