Objectives: To compare maternal and neonatal outcomes when primary Cesarean delivery is performed in the second stage of labor compared with that performed in the first stage of labor.Methods: Between September 1, 2008, and March 1, 2009, a prospective observational study of primary Cesarean deliveries was conducted at Cairo University in the Obstetrics and Gynecology Emergency Department in El-Kasr El-Aini hospital. The primary outcomes of interest included a maternal composite (composed of at least one of the following: intraoperative surgical complications, blood transfusion, endometritis or wound complications) and neonatal composite (which included at least one of the following: fetal injury, Apgar score of 3 or less at 5 minutes, delivery room intubation in the absence of meconium neonatal intensive care unit admission, seizure, or neonatal death).Results: A total of 60 Cesarean deliveries were available for analysis: 30 cases were performed during the first stage and 30 cases in the second stage of labor.