Introduction: The rising trends in the cesarean sections are an issue of the international public health concern. These rising trends are not uniform throughout the world. In the developing countries, like India it varies between 17-60%. Objectives : To study the incidence and the determinants of cesarean deliveries in two major hospitals of Sikkim and it's correlation with demographic factors like parity and maternal age. To quantify the factors responsible for these changing trends. Materials and methods, This retrospective study was carried out during the period of 2004- 2008 in two major hospitals of the Sikkim.