Evaluation of performance toward cesarean section in Kasr El Aini Obstetrics and Gynecology hospital in an attempt to define the causes of the increased cesarean rate and how to manage. The study was conducted in Kasr El Aini Obstetrics and Gynecology hospital. Records of women who underwent cesarean sections at the Obstetrics department from the 1st of January 2008 to the 31st of December 2009were retrospectively reviewed. Which takes into account characteristics such as age, parity, period of gestation, labor status, indication of cesarean delivery, co morbidities, complications and mortality. Cesarean deliveries were performed with an incidence of 38.9%in 2008 and37.9% in 2009. Repeat cesarean section is the main indication, large proportion of patients were having previous one cesarean with an incidence of about 30% in both years.