A review of a 38-year experience with cesarean section at a community hospital shows considerable change in both the rate and indication for cesarean sections. A marked increase in the cesarean section rate was noted after 1972. This increase was due primarily to an increase in the primary cesarean section rate for cephalopelvic disproportion and labor abnormalities, fetal distress, and the breech presentation. As a result of this study, we anticipate a primary cesarean section rate of approximately 10%: 3–5% for cephalopelvic disproportion and labor abnormalities, 1–1 1/2% for fetal distress, 3% for breech presentation, and 1–2% for all other indications.