Background:The Primary caesarean section (CS) delivery worldwide rate is increasing due to public interest to avoid fetal complications and acceptance by most of the couple to complete their family with one or two children. This study was undertook to study selected cases of primary CSs in primigravid women, keeping the objectives to study the complications lead to cesarean section, maternal morbidity and mortality. Methods:Cross sectional survey conducted among Primigravidae in maternity & Pediatrics hospital – Abha – obstetrics & gynecology department between January 2016 and December 2016. Overall 170 cesarean section has been done out of 1167 births. Conclusion: Preeclampsia, eclampsia, placenta previa, intrauterine growth restriction, macrosomic fetus, malpresentation of the fetus, loss of fetal moment, fetal distress and labor dystocia are all indication of cesarean section. Our study revealed that cesarean section among Primigravidae still low in our area of the study.