Since compromises must be accepted in emergency Caesarean sections in respect of preparation, anaesthesia and hygienic standards, 143 emergency caesarean sections out of a total number of 37,583 deliveries were analysed during 1981-1990 from four different obstetrical departments as well as risks, complications, maternal and foetal morbidity and mortality were studied. In connection with these operations, which are not influenced only by medical factors but also by logistics, two mothers died (1.4%). Perinatal mortality was 3.3% (unpurified perinatal mortality: 8.5%). Neither the influence of time, when the Caesarean section was performed, nor the place of operation (theatre or labor bed), nor the indication for the operation on foetal outcome and maternal morbidity were found. Maternal morbidity was mainly contributed to pre- and intraoperative bleeding. Intraoperatively 12.6% and postoperatively 10.5% of the patients had to be given heterologous blood conserves. In more than a third of the newborn, which had been delivered by emergency Caesarean section, because of a pathological cardiotocogram, the pH values showed no pathological findings. The benefit of an antibiotic prophylaxis in emergency Caesarean sections could be significantly demonstrated, showing the different rates of secondary healing complications. A particular problem exists in emergency Caesarean sections for the delivery of the second twin following spontaneous delivery of the first one (2.8%).