Introduction Sternotomy remains a commonly used technique to access the heart for cardiac surgery worldwide. To date, there is no clear consensus on the single superior sternal closure technique. Methods The aim of this study was to explore the optimal sternal closure technique post adult-cardiac-surgery. A retrospective study of all patients undergoing cardiac surgery via sternotomy in 2021 was conducted at a quaternary-hospital. Results were analysed following sternal re-approximation using wires, cables or plating in the short-term and at 1-year follow-up. Results There was a trend towards superior outcomes in terms of sternal union, reduction in long-term complications and decrease in need for surgical reintervention, IV antibiotics or readmission following wire-closure versus cable-closure. The results were equivocal amongst patients who had wires versus plating. While there was a higher rate of short-term complications in the wire group, this did not result in a higher need for further active management. It was also observed that risk factors including diabetes, obesity, emergency surgery & the need to return to theatre increased the patient’s risk for short term post-op sternal complications including superficial and deep infections, wound dehiscence and sternal non-union. Conclusion This study would support the use of wires as the superior sternotomy closure technique when taking into account the lower cost profile of wires versus sternal plating with equivocal sternal outcomes. There was statistically significant higher rates of long term complications, sternal non-union and increased need for reintervention, readmission and IV antibiotics following the use of cables for sternal closure.