Background: Pelvic floor dysfunction caused by multiple factors is a complicated process. As life expectancy rises, so does the prevalence of PFD, which includes pelvic organ prolapse (POP), sexual disorders, and lower urinary tract excretory and defecation abnormalities such as overactive bladder, pelvic organ prolapse, and urine and anal incontinence. This study aimed to evaluate the association between type of delivery and pelvic floor structure changes in Zagazig University Hospitals. Methods: A cohort study conducted at Zagazig University Hospitals in Obstetrics and Gynecology Ultrasonography unit, utilizing a Mindray Dc-70 ultrasound machine. Patients were separated into two groups (24 vaginal deliveries and 24 cesarean deliveries). All women underwent a thorough history taking, general examination, pelvic examination, and transperineal ultrasonography. Results: There were no statistical significance differences between the studied groups in bladder neck rotation. But there was a statistical significance increase in bladder neck descend among NVD group compared to CS group. There was a statistical significance decrease in detrusor muscle thickness among NVD group compared to CS group. There was a statistical significance increase in frequency of pelvic organ prolapse and stress incontinence among NVD group compared to CS group. There was a statistically significant decrease in mean MOS score among NVD group compared to CS group. Also, there was a statistically significant increase in frequency of UPFMC among NVD group compared to CS group. Conclusion: it appears that vaginal delivery is associated with more negative effects on pelvic floor structure and function compared to cesarean section delivery.