Background: Intra-peritoneal adhesions are one of the most common complications seen in repeated cesarean sections and are difficult to diagnose, rates of adhesion development recorded at a second cesarean delivery (CD) are lower and ranged from 24% to 46%,objectives: to investigate whether cesarean scar characteristics and Trans-abdominal ultrasound could predict the presence and severity of intra-peritoneal adhesions for patients with previous one cesarean delivery ,Patients and Methods: This is a prospective cohort study was conducted at department of obstetrics and gynecology in Aswan university hospital between  July 2017 and June 2018 our study included all pregnant women with previous one c.s , all the participant were examined abdominally followed by ultrasound examination to detect signs of intra-peritoneal adhesions and then followed up to delivery in which the intra-operative characters and outcomes of adhesions are reported, Results: Our results showed that women with depressed/elevated scars and abnormal movement on US are at increased risk of development of post-CS adhesion with a  total number (%) of the patients diagnosed with adhesions was 70 (58.3%) .Conclusion both abdominal scars' characteristics and trans-abdominal US are useful tools for the prediction of the development intra-abdominal adhesions among women with repeated CS.