Background: Hypotension during spinal anesthesia for caesarean delivery remains a common clinical problem. It has a risk factor for adverse maternal and fetal events. This study aimed to evaluate the effectiveness of lower leg compression maneuver in reducing spinal anathesia induced hypotension for women undergoing cesarean Section. A Quasi-experimental designwas utilized in the current study.Setting: The study was conducted at cesarean delivery unit in Mansoura University Hospital during the period from October 2016 to March 2017.Asystematic random sample was calculated to be 220 of women underwent elective cesarean delivery with spinal anesthesia to be recruited in both study group and control group. Pre-hydration and anesthetic technique standardized protocol was followed. Hypotension defined as a decrease in any mean arterial pressure (MAP) measurement by more than 20% of the baseline. Tools:Three tools were used in the current study to collect the necessary data, Structured interviewing questionnaire sheet, maternal hemodynamic and signs of hypotension record, and neonatal assessment sheet. Results: A highly statistical significant difference was found between study group and control group regarding mean arterial pressure and neonatal acidosis .Conclusion: lower leg compression for women under elective cesarean with spinal anesthesia is more effective measure to reduce spinal anathesia induced hypotension during cesarean delivery. Recommendations: lower leg compression during cesarean delivery should be included in maternal hospitals protocol for reducing spinal induced hypotension during cesarean delivery.