Introduction: The choice of anesthetic technique for cesarean section can significantly impact maternal and neonatal outcomes. This study aimed to compare spinal anesthesia (SA) and general anesthesia (GA) for cesarean deliveries in terms of maternal and neonatal outcomes. Methods: A prospective, observational study was conducted over six months at a tertiary care hospital. 202 patients undergoing cesarean section were enrolled, with 101 receiving SA and 101 receiving GA. Maternal outcomes included postoperative pain scores, time to first analgesia request, incidence of postoperative nausea and vomiting (PONV), time to mobilization, and maternal satisfaction. Neonatal outcomes included Apgar scores, umbilical cord pH, need for resuscitation, and NICU admission. Breastfeeding initiation rates were also assessed. Results: SA was associated with significantly lower postoperative pain scores at 6 hours (3.2 vs 5.7, p<0.001), longer time to first analgesia request (210 vs 65 minutes, p<0.001), lower incidence of PONV (24.8% vs 44.6%, p=0.003), and earlier mobilization (8.5 vs 12.3 hours, p<0.001). Maternal satisfaction was higher in the SA group (4.2 vs 3.5, p<0.001). Neonates in the SA group had slightly higher 1-minute Apgar scores (median 9 vs 8, p=0.03) and lower rates of resuscitation (5.0% vs 14.9%, p=0.02). Breastfeeding initiation within 1 hour was more frequent in the SA group (70.3% vs 44.6%, p<0.001). Conclusion: Spinal anesthesia demonstrates advantages over general anesthesia for cesarean section in terms of maternal postoperative outcomes, satisfaction, and early breastfeeding success, with slightly better immediate neonatal adaptation. These findings support the preferential use of spinal anesthesia when appropriate, while maintaining proficiency in both techniques to ensure optimal patient care.