Objective: To determine and compare the rate "and indications for caesarean section at four year interval. Method: Retrospective analysis ofcaesarean sections done in 2003 and 2007. Results: An increase in the rate of caesarean section was found from 20.03% ( 1164/5810) in 2003 to 23.80% ( 1492/6269 ) in 2007. In 2003 versus 2007, foetal distress [ 42.96% ( 500/1164) vs 38.94% (581/1492 )] J. previous history of caesarean section 13.57% ( 158/1164 ) vs 24.73% (369/1492 )] J, breech [ 9.11% (106/1164) vs 8.51% ( 127/1492] j and non progress of labour [ 5.67% ( 66/1164) vs 5.70% (85/1492 )] J formed the main indications.