Open fractures are still considered a major challenge for surgeons and frequently require a series of complex surgical procedures for achieving proper limb function. Documented incidence of infection in open wound fractures varies in the literature. Objective: To determine the frequency of different organisms cultured from open fractures within 24 hours of presentation at Department of Orthopedic Surgery, Khyber Teaching Hospital, Peshawar from 1st January to 31st December 2019. The duration of the study was 01 year. A total of 162 trauma patients with an open fracture of extremities who presented within 24 hours after trauma were studied and cultures from their wounds were collected. Results: Gender-wise distribution among 162 patients showed 88(54.3%) as male and 74(45.6%) as female. The mean age was 27.23±3.633. Fractures distribution according to the anatomic location showed 74(45.67%) patients with tibia fractures, 23(14.19%) with the femur, and 18(11.11%) with ankle fractures. Micro-organism distribution showed Staphylococcus aureus as 43(26.8%) Streptococcus 33(20.37%), Staphylococcus Epidermidis 28(17.28%), E. coli 21(12.96%), and Klebsiella aerogenes in19 (11.72%) cases. Conclusion: All open compound fractures should be considered infected until proved otherwise. The patient needs good antibiotics coverage both for Gram-positive and negative coverage besides wound care till the availability of the culture and sensitivity reports. [ABSTRACT FROM AUTHOR]