Perineal healing was compared between 181 women with episiotomies and 186 women without episiotomies at one to two weeks after delivery. Subjects were medically indigent low-risk women who had normal spontaneous vaginal deliveries at the same tertiary-care hospital. Maternal age, race, parity, and birth weight did not have an independent effect on perineal healing. Perineal outcome at delivery and length of second stage exhibited a significant relationship with perineal healing. Overall, there was a 4.9% incidence of delayed perineal healing due to wound separation or clinical infection. In the episiotomy group, 7.7% of the subjects experienced delayed perineal healing compared with 2.2% in the no-episiotomy group. This was statistically significant using Pearson chi-square analysis. These results suggest that women without episiotomies exhibit better perineal healing than women with episiotomies.