Background: Caesarean section when indicated is a life saving procedure but when performed without appropriate indications can add risk to both the mother and baby. However over the past 15 years it has been noted that the incidence of caesarean section has doubled all over the world, different regions having different caesarean rates which has become a serious public health issue as morbidity and mortality from an unindicated caesarean section is more than from a vaginal delivery. The present study was done as there are no studies conducted in Northeast, India and in the tribal population to know the rate of primary caesarean section in primigravida & multigravida and to know the aspects which need due attention in either group (primigravida or multigravida) which can be differentiated for better obstetric management. Aim & Objectives: 1) The primary objective is to compare the rate of primary caesarean section in primigravida and multigravida. 2).The secondary objective is to compare the indications, maternal complications, early neonatal outcome in primigravida and multigravida. Material and Method: Study population- This study consisted of two groups, group A consist of 160 primigravida who fulfil the inclusion and exclusion criteria. Similarly, group B consist of 160 multigravida who fulfil the inclusion and exclusion criteria. Inclusion criteria: 1) All primigravida (booked and unbooked) with gestational age more than 37 weeks and above who have come for delivery. 2) Multigravida upto gravida 5 with gestational age of more than 37 weeks and above who has had one previous viable vaginal delivery. Exclusion criteria: 1).Patient with nonviable pregnancy 2) Patient not willing to participate in this study. 3) Patient having previous history of myomectomy or hysterotomy. 4) Gravida 6 and above as they are prone to complications. Results: The overall incidence rate of primary caesarean section rate in this study is 58.75% in primigravida and 31.87% in multigravida. Maximum patients who underwent primary caesarean section were in the age group 20-25years and 25-30 years for both groups. Maximum of the patients were posted for emergency caesarean section 96.8% in primigravida and 94.1% in multigravida. Foetal distress was the commonest indication 54.95% in primigravida and cephalopelvic disproportion 47.92% in multigravida. Intra-operative complications were common in both groups. In multigravida PPH 77.3% was more common. However uterine wound extension 80% was more common in primigravida. The overall post-operative complications were more common in multigravida (25.49%) compared to 13.82% in primigravida. Early neonatal outcome was good in both the groups. There was only 1 neonatal death during the study period in group B. Conclusion: As we have witnessed an increased rise in the rate of caesarean section over the past few years it is our responsibility to bring out the change and modifications and note that the indications indicated for caesarean section should be genuine. From this study, we can also see many females having no antenatal check-up which we can help by creating awareness and importance of antenatal check-up and should train doctors for timely referral of patients to avoid unnecessary complications. The need to better improve skills of obstetricians and staff to read CTG, perform ECV, perform instrumental deliveries especially in second stage of labour, proper counselling of patients and availability of labour analgesia to decrease the rate of caesarean on request. The overall reduction in caesarean rate can only be reduced if the indications of primary caesarean sections can be analyzed.