Objective : Evaluation of performance toward cesarean section in Kasr El Eini Obstetrics and Gynecology hospital in an attempt to define the causes of the increased cesarean rate and how to manage. In addition, the study evaluates the safety of cesarean section as a procedure.Methodology: The study was conducted in Kasr El Eini Obstetrics and Gynecology hospital. Records of women who underwent cesarean sections at the emergency department from the 1st of January 2007 to the 31st of December 2007 were retrospectively reviewed. Which takes into account characteristics such as age, parity, period of gestation, labour status, indication of cesarean delivery, procedures applied, comorbidities, complications and mortality. Collected data were used in a descriptive design to provide numerical summaries of different parameters. Results: Cesarean deliveries were performed with an incidence of 37.03%. Repeat cesarean section is the main indiction with an incidence of 47%. large proportion of patients were having previous one cesarean 65.7%. the overall incidence of complications is 1.87%. The incidence of postoperative febrile morbidity following cesarean delivery is 0.82%; Atonic postpartum haemorrhage and DIC occur in an incidence of 0.63% and 0.09% respectively. The frequency of Peripartum hysterectomy in our study is 0.15%. No mortalities related to cesarean section as a procedure.Conclusion: The incidence of cesarean section in Kasr El Eini Obstetrics and Gynecology hospital is markedly increased over the time period from 1997 (21.86%) to 2007 (37.07%). The most common indications were repeat cesarean, dystocia, nonreassuring fetal condition and breech presentation. Repeat cesarean is the major indication. The safety of cesarean section is relatively increased