Rationale of the study: Against the background that Cesarean section rates are on the surge, a lookback into the indications of emergency Cesareans would help us identify where we should focus on to reduce the total Cesarean rates. Methodology: Retrospective observational study at Amala Institute of Medical Sciences, Thrissur including all emergency Cesarean patients during the year 2018. Results: Cesarean rates showed an increasing trend over the past 5years. Of all the patients who underwent Cesarean, 56.8% were emergency Cesareans. The overwhelming majority was done for previous CS(28%), followed by cephalopelvic disproportion with failed trial of labor(19.2%), failed induction(14.5%) and fetal distress (14.5%). Conclusion: There are so many factors leading to increasing Cesarean sections; and determining the most important contributing factor gives us a place to begin with. We should strive together to help fulfill the dream and aspiration of every pregnant woman to deliver normally to a healthy baby.