OBJECTIVE To compare Pfannenstiel-Kerr (PKM) and Misgav-Ladach (MLM) methods in terms of operation-related features and neonatal outcome in primary cesarean deliveries. METHODS A total of 180 pregnant women randomized into PKM (n = 90) or MLM (n = 90) groups were included in this study. Primary outcome measures were total operative and extraction times, Apgar score, blood loss, wound complications, and the suture use. Secondary outcome measures were wound seroma and infection incidence, time of bowel restitution, and the perceived pain. RESULTS Total operation and extraction times were significantly shorter and less suture material was used in the MLM group than the PKM group (p < 0.001). Initially, higher scores obtained for 6 h-VAS in the MLM group (p < 0.05) were normalized after 24 h of the operation. PKM and MLM were similar in terms of preoperative and postoperative levels of hemoglobin and hematocrit, wound complication, bowel restitution, fever, seroma, infection, wound dehiscence and the need for transfusion, antibiotic, and analgesics. CONCLUSIONS The operation-related morbidity of the MLM and PKM for primary C/S seem to be comparable; however, the MLM seems to be superior in terms of operation time and the amount of suture usage but inferior in pain scores in the early postoperative period.