Opioid-related mortality is a patient safety concern. Prior studies have demonstrated that postdischarge opioid prescribing can lead to chronic use in opioid-naïve patients. This retrospective observational study examined the amount and duration of opioid prescribing following 25 common elective surgical procedures. Nearly all patients were prescribed opioids after elective surgery. The median amount of opioids prescribed, 375 oral morphine equivalents, was nearly twice the maximum recommended. Quantity of opioids prescribed differed by sex, body weight, age, and diagnosis, and there were also significant variations among the three institutions included in the study. The authors call for standardizing and optimizing postsurgical opioid prescribing.