820 Cesarian sections were performed between 1967 and 1976 at the Gynecological Clinic of the Ludwigshafen Municipal Hospital. These sections are reviewed in the following study under the following aspects: 1. Indication 2. Maternal Morbidity and Lethality 3. Perinatal Lethality 1. Corresponding to the trends reported in current literature, the frequency of Cesarian section increased from 1967 to 1976 by 2.6% to a maximum of 11.4%, the average figure for the last years being 9%. Performance of Cesarian section due to maternal indication remained practically constant at 5%, whereas section performed for fetal indication predominated (61.6%). This is due, among other things, to the changed indication for Cesarian section in primigravidae with breech presentation, representing about one-fifth of all Cesarian sections. The proportionate share of the mixed indication is 33.4%, whereas that of the extended indication is 13.7%. 2. Maternal morbidity is 22.5%; this includes all postoperatively occurring diseases. Complications of a relatively severe nature were recorded in 4.9% of the cases. Postoperative disturbances are much rarer after primary Cesarian section (6.6%), than in cases with indication for Cesarian section when birth had started (16%). Three women died during the period under report (3.6%). The casuistics of these cases are reported. This included one patient with a surgical disease (penetrated gastric ulcer), so that actual mortality associated with parturition in only 2.4%. In 271 primary Cesarian sections, the mortality was 0%. 3. 35 children died out of the total of 850 infants (4.1%), whereas the purified perinatal lethality is 2.1%.