**Abstract**

Cesarean section rate has been on the rise. It is commonly perceived as a simple and safe alternative to difficult vaginal birth. However, there are situations during C section where delivery of fetus may be difficult. There are multiple reasons for a cesarean section to be difficult such as poorly accessible lower segment, difficult fetal extraction, abnormal placentation, and visceral injuries. If the difficult cesarean section is not handled properly, it is high likely that the procedure will end up in catastrophic maternal and neonatal outcome. To avoid such disaster, it is imperative to have sufficient knowledge on anticipation, planning, and appropriate conduct of the procedure. Thus, this chapter aims at guiding practitioners on the management of common causes of difficult cesarean section.

**Keywords:** difficult CD, complicated CD, extensive adhesion, transverse lie, uterine incision
