High cesarean birth rates are an issue of international public health concern.1 Worries over such increases have led the World Health Organization to advise that Cesarean Section (CS) rates should not be more than 15%,2 with some evidence that CS rates above 15% are not associated with additional reduction in maternal and neonatal mortality and morbidity.3 Analyzing CS rates in different countries, including primary vs. repeat CS and potential reasons of these, provide important insights into the solution for reducing the overall CS rate. Robson,4 proposed a new classification system, the Robson Ten-Group Classification System to allow critical analysis according to characteristics of pregnancy (Table 1). The characteristics used are: Table 1 Robson’ 10-Group Classification. single or multiple pregnancy nulliparous, multiparous, or multiparous with a previous CS cephalic, breech presentation or other malpresentation spontaneous or induced labor term or preterm births. This classification system has been used in single-institution studies, jurisdictional, and national registries and recently with international comparisons.5,6 The aim of this study was to investigate CS rates at a tertiary care centre in Oman and make analysis based on the 10-group classification.