WHO advises that lower segment cesarean section (LSCS) rates should not be more than 15%. A caesarean section (CS) is a life-saving surgical procedure when certain complications arise during pregnancy and labour. However, it is a major surgery and is associated with immediate maternal and peri-natal risks and may have implications for future pregnancies. Worldwide, CS rates increased up to 3 times in 14 years, from 6.7% in 1990 to 19.1% in 2014. Objectives: To determine the rate of LSCS

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... es and pattern of indications for LSCS in a tertiary care maternity hospital in Kashmir. Methodology: An observational study was carried out where in all the pregnant females who delivered in the month of December in a tertiary care hospital were enrolled in the study. The mode of delivery was ascertained and in case of LSCS, the primary indication for LSCS was noted down. Results: In our study total number of deliveries were 1823 including 663 (36.36%) vaginal deliveries and 1160 (63.63%) LSCS. The commonest indication of LSCS was previous caesarean section in 37.2% followed by acute fetal distress (21.6%) and cephalo pelvic disproportion (CPD) 10.6%. Conclusion: The LSCS rate in our study is very high compared to the WHO standards and previous LSCS is the commonest indication followed by AFD and CPD. It is an eye opener to health care policy makers and other stakeholders, to formulate the guidelines for the absolute indications of Caesarean section.