Background: Approximately 20 million deliveries globally involve cesarean sections (CS), the most common abdominal surgery performed annually on humans. In order to reduce morbidity and mortality, the goal of this endeavor is to lower the rate of primary CS. Methods: This retrospective study was conducted at Faculty of Medicine, Zagazig University based on secondary data retrieved from the record information of the registry of Zagazig Maternity University Hospital from 2019 to 2023 during the period from January 2024 to June 2024. Results: The most frequent cause of cesarean section among primigravidae mothers was fetal distress among 1159 cases (35%) of mothers. Breech was the second indication for CS in 463 cases (14%), followed by Cephalopelvic disproportion in 397 cases (12%). The other indications included Obstructed labor in 331 cases (10%), Failed progress in 298 cases (9%), Failed induction in 265 cases (8%), Antepartum eclampsia in 165 cases (5%), IUGR in 32 cases (4%), Abruptio placenta in 33 cases (1%), Precious pregnancy in 33 cases (1%), and Transverse lie in 33 cases (1%). The most frequent complication seen among primigravidae among pregnant women who gave a birth by cesarean section was uterine atony & PPH and Respiratory tract infection was in 232 cases (7%) of mothers, Extension of uterine incision, UTI and Wound gap in 66 cases (2%). Conclusion: Although the operation is safe now days, it is still carries a risk during anesthesia, operative procedure and postoperative. Moreover, there is a great risk of major complications in the next pregnancies.