For cesarean section, during 2003 and 2010, after a gap of 7 years and to evaluate, how the implementation of universally acceptable standards, affects rate of cesarean section without compromising maternal and fetal safety. Study Design: Comparative study. Place and Duration: Department of Obstetrics & Gynecology at People's Medical College Hospital Shaheed Benazirabad in January 2011. Material and Methods: In this comparative study, two years data i.e. of 2003 (Group- 1) and 2010 (Group-2) was collected from the hospital record. Both groups were compared for cesarean section rate and trends of indications of cesarean section. Results: The results revealed that, in year 2003, the rate of cesarean section was 29.70 % and in year 2010, it rose to 36.96 %. In both years, the highest indication of cesarean section was multigravida i.e. 46.50 % (n = 400) in year 2003 and 55 % (n = 1011) in year 2010. During both years, the main indication of cesarean section was previous cesarean section, dystocia, fetal distress, placenta previa and breech presentation. Conclusion: It is suggested to have obstetric audits by independent marital meetings to assess the intrinsic role of cesarean section in influencing the feto-maternal outcome.