Background: The objective of this manuscript is toexplore perceptions of health workersregardingthe use of vacuum extraction, two years after the implementation of training programme, in Mulago Hospital, Uganda. Methods: A cross-sectional survey among midwives, residents and consultant obstetricians,was performed. It was composed of questions pertaining to vacuum extraction, addressing reasons for low use, recommendations to increase use, preferred mode of birth, views aboutwho is suited to perform the procedure and contraindications.Results: Eighty-threeof 134(61.9%) participants returned the survey. The most frequent reasons for low use of vacuum extraction were lack of training (60/83, 72.3%) andequipment (59/83, 71.1%). Skills training and improved supply of equipment were recommended. Most participants (57/83, 68.8%) chose vacuum extraction over caesarean section as hypothetical mode of birth forthemselves or a relative. There was a tendency to cite contraindications not identified as such in international guidelines (big baby, caput succedaneum, moulding). Midwives and doctors with appropriate training were generally allconsideredsuited to perform vacuum extraction. Conclusion: Health workers generally conveyed a positive attitude towards vacuum extraction, despite some perceived barriers, often unsupported by evidence.Organisation of skills training, supply of equipment and focus on knowledge of indications are essential to increase its use.