Background: A cesarean section is a surgical procedure that when undertaken for medical reasons can save the life of women and their babies. The primary cesarean section rate is increasing. Many cesarean sections are undertaken unnecessarily, however, which can put the lives and well-being of women and their babies at risk—both in the short-term and in the long-term. Aims and objectives: To determine the rate, antenatal risk factors, indications, intraoperative, and postoperative complications of cesarean delivery in primiparous women. Materials and methods: This was a retrospective study conducted from January 2019 to December 2019. The study included all primiparous women who delivered by cesarean section after 28 weeks of gestation. The detailed information was collected from the records and then analyzed. Results: The total number of deliveries during the study period was 790; out of which cesarean deliveries were 456 (57.72%), and the number of primiparous women who underwent cesarean section was 150 (18.98%). The most common age-group in the study group was 18–25 years. Out of 150 women, 32 (21.33%) were preterm, 86 (57.34%) were term, and 32 (21.33%) were postdated pregnancy, respectively. Most (101/67.34%) of them were unbooked, while 49 (32.66%) were booked cases. The most common antenatal risk factors were anemia (43.34%) and postdated pregnancy (21.34%). The most common indication of cesarean section was non-reassuring fetal heart rate (FHR) (22%). Out of 150 women, 103 (68.66%) had undergone emergency cesarean section. Intraoperative and postoperative complications were less. There was one maternal mortality (0.66%) postoperatively during the study period. Conclusion: When medically necessary, cesarean delivery can effectively prevent maternal complications. Hence, women who need cesarean section should be identified accurately to reduce the rate of cesarean section in primipara and also to reduce maternal complications in short and long terms.