Aim: Use of chemotherapy has a big role in cancer breast treatment. This study is done to determine the impact and timing of neoadjuvant and adjuvant chemotherapy on postoperative outcomes after mastectomy with immediate breast reconstruction. This study was done in Zagazig University Hospitals, Egypt. Methods: Retrospective study including 82 patients underwent mastectomy and immediate breast reconstruction with Intervention Systemic neoadjuvant and adjuvant chemotherapy for breast cancer during the period of study (January 2017 to December 2018), with a postoperative follow-up of two years at Zagazig University Surgical Department. Results: Nine patients (45%) in the adjuvant chemotherapy developed postoperative infections, compared with seven patients (25%) in the neoadjuvant chemotherapy group and 8 patients (24%) who did not receive any chemotherapy (p = 0.05). Overall, 30% of patients had a complication requiring an unplanned return to the surgical room. Conclusion: The adjuvant chemotherapy group had high rate of infected wound but there were no differences between groups with respect to unplanned reoperation, donor-site complications, or expander loss.