Background: The purpose is to study the indications of caesarean section done in the institution. The knowledge thus obtained would help us to suggest the measures which should be taken to decrease the rising trend of caesarean in our society. Aims & objectives: The study aims to explore the indications of caesarean section along with their sociodemographic and obstetric determinants to identify factors that are needed to be addressed in order to decrease the rising trend of caesarean section. Materials & methods: This is a cross-sectional study conducted at NMCH, Patna from September 2022 to August 2023. All patients who underwent caesarean section were included in this study and their indication for caesarean was studied. Results: 1510 women underwent caesarean from September 2022 to July 2023. Of this, majority of caesarean section indications included repeat C-section (30%), foetal distress (22%), referral from PHCs(18%),bad obstetrics history(3%) , due to failed induction (7%) etc. Conclusion: Increase in caesarean section causes burden to the general health system & also on the family members. Hence, caution should be taken in decision making to perform caesarean section especially for primigravidas