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Objectives: While bilateral tubal ligation has historically been performed for sterilization at cesarean delivery, recent data supports the use and safety of opportunistic bilateral salpingectomy ( during cesarean delivery (CD) to decrease lifetime ovarian cancer risk. Prior studies have described racial disparities in sterilization rates, but there is a paucity of data regarding racial disparities in type of sterilization procedure. Our objective was to determine differences in sterilization procedure type performed at CD by race (Black vs. non-Black) to evaluate for equity in bilateral salpingectomy utilization. Study Design: We performed a retrospective cohort study of patients included in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database who underwent sterilization at time of CD from 1/2019-12/2020, identified using current procedural terminology codes. Patients without documented race were excluded. Multivariable logistic regression was used to determine odds of undergoing bilateral salpingectomy compared to bilateral tubal ligation by race while controlling for confounders. Results: Of 28,147 patients who underwent CD, 3,087 underwent concurrent sterilization procedure, and 2,161 met inclusion criteria (Black n=279; non-Black, n=1,882). Black patients were significantly more likely to have hypertension (10.8% vs. 5.3%, p < 0.01), bleeding disorders (3.9% vs. 1.3%, p < 0.01), pre-operative anemia (hemoglobin<11g/dL) (36.9% vs. 21.3%, p < 0.01), and be of American Society of Anesthesiologist class 3 or higher (29.4% vs. 22.5%, p=0.01) than non-Black patients. After adjusting for differences, Black patients were almost 50% less likely than non-Black patients to undergo bilateral salpingectomy compared to bilateral tubal ligation for sterilization at CD (aOR 0.52, 95% CI 0.36-0.75). Conclusion(s): Despite evidence that bilateral salpingectomy decreases ovarian cancer risk and is safe at CD, there is a racial disparity in bilateral salpingectomy utilization. While the cause of this disparity is unclear, further research is warranted to determine root causes and equitable solutions.