Caesarean section (CS) could cause considerable physical, psychological, financial and emotional stress. Hence, patients' involvement in the decision to have a CS and satisfaction with the procedure are important in the care of women requiring CS. The aim of this study was to assess women's involvement in decisionmaking before CS and its influence on their satisfaction with the procedure. The study was carried out in tertiary health institution, Edo State, Nigeria among women who have had CS. The objectives of the study were to determine if women are involved in the decision making for CS, identify the factors affecting women's decision and assess the satisfaction of women with the procedure of CS. A descriptive crosssectional study was utilized. A convenience sample of 215 respondents was studied. The data were collected with the use of a semi structured questionnaire. Data were analyzed with Scientific Package for Scientific Solution (SPSS). Chi-square was used to test the hypothesis on the association between involvement in decision-making and satisfaction with CS.The result of the study showed that 56.3% of respondents were in the age group of 21-30 years. Over 88% of the respondents were told that they were going to have a CS while 84.2% consented to the procedure. Only 36.2% directly signed the consent forms. There was a statistically significant association between involvement in decision-making and satisfaction with CS (p = 0.000).It was concluded that health care providers should continue to provide adequate information on CS to women who have indication for it so as to enhance their involvement in the decision-making process.