Background: Caesarean delivery or abdominal delivery is a common intervention in current obstetric practice which has significantly reduced maternal and neonatal morbidities and mortality. The World Health Organization (WHO) in 1985 pegged the acceptable rate at 10-15% but the rate of caesarean sections has been increasing in both the developed and developing countries. However, the rates have been exceeded in many developed countries while in the developing countries with a lot of unmet needs, the rates are quite low. When absolutely indicated, the rate should not prevent the timely recourse to the procedure which is life-saving. Aim: The aim was to determine the rate of caesarean section in ESUT Teaching Hospital over t a 3-year period. Materials and Method: This was a retrospective study of all the caesarean sections done in ESUT Teaching Hospital Enugu from December 31, 2020 to January 1, 2018. The necessary data was collected from the registers of the theatre and labour ward of ESUT Teaching Hospital and patients’ case notes using a structured proforma. Statistical Analysis: Data collected from the study was analyzed with the Statistical Package for Social Sciences (SPSS) computer software for Windows version 20.0. Results were presented using simple percentages, frequencies and tables. Result: Out of the 4719 deliveries in the centre over the period, the caesarean rate was 29.6% out of which 73.7% were booked; 26.3% unbooked; 59.2% were emergencies and 40.8% elective. The major indications were previous caesarean 20.2%, hypertensive diseases in pregnancy 14.6% and poor progress of labour 11.4%. Maternal complications were PPH, 8.4%; UT injuries, 2.9% and maternal death, 0.5%. The neonatal intensive care admission was 2.49% and neonatal death, 8.5%. Conclusion: There is a relatively high caesarean section rate in ESUT Teaching Hospital when compared with the Nigerian national figures but this is still lower than what is obtainable in the developed countries.