The rate of cesarean section (CS) has considerably increased in both developed and developing countries, despite it being recommended for medical indications. Aim: To assess the determinants of primigravida preference regarding mode of delivery. Design: Descriptive design was used in this study. Setting: The study was conducted at antenatal care clinic affiliated to Beni-sueif University Hospital, Egypt. Sample: Purposive sample of 100 primigravid women.Tools: two tools were used; Tool (I): Structured interviewing questionnaire, Tool (II): Determinants of delivery mode questionnaire. Result: Around 50% of primigravida, in the age range of 20 to 25 years, expressed their preferences for the mode of delivery. Among these women, more than two-thirds preferred cesarean section (CS), while nearly one-third preferred vaginal delivery (VD). The majority of primigravida who did not prefer VD cited reasons such as fear of experiencing severe pain during childbirth, anxiety about the possibility of vaginal opening expansion or tearing, and fear of undergoing an episiotomy. Almost primigravida who chose CS mentioned reasons such as not wanting to wait for the onset of labor pain,usage of analgesics during CS, and the perception that CS is less painful. Conclusion: Primigravida overwhelmingly preferred (CS) as their mode of delivery. Several determinants had a positive impact on their preference for CS over (VD), the desire to avoid the intense pain with labor, fear of episiotomy, anxiety about vaginal tearing; influenced primigravida's preference for CS over VD. Recommendations: Development of educational programs to increase the primigravida awareness, knowledge and practices regarding both mode of delivery.