Introduction: “Every effort should be made to provide caesarean sections to women in need rather than striving to achieve a specific rate” WHO Statement (2015) Since1990 to 2014, the overall worldwide absolute increase in the CS rate was 12.4% with an estimated average annual increase in rate of around 4.4%. Methods: This retrospective study was conducted at Department of Obstetrics and Gynaecology Aswan University, Aswan, Egypt.The study period was from January 2018 - December 2018. Data was recorded, master chart framed and a statistical analysis of various parameters- age, parity, period of gestation, and indications for CS in primigravida/multigravida/overall, was done to find out the rate and trend of CS in our hospital. Results: During the study period(January 2018, to December2018) a total of 3852 patients were delivered and 2400(67%) patients had vaginal delivery, 1452 (37.69%) patients had undergone caesarean section and 712(18.48%) patients had undergone primary caesarean section. The most common indication for primary CS were foetal distress 25% followed by Failed induction 17.83%. (77.52%) of caesarean section were done at term gestation. (10.25%) patients had undergone primary caesarean section at <37 weeks of gestation while 12.21% cases were post-dated pregnancies. Conclusion: CS rates have increased primarily due to foetal distress followed by Failed induction. To reduce the rate of CS the rate of primary CS needs to be reduced by proper selection of patient for CS for indications like foetal distress, non-progress of labour.