OBJECTIVE: To investigate the trend of cesarean section (CS) delivery rate and CS indications between January 2009 and December 2013 at Hassan II Hospital, Settat, Morocco. STUDY DESIGN: The demographic characteristics of women who gave birth at the hospital during the study period were collected. A total of 36,965 puerperal patients (aged 14–52 years at 33–42 weeks’ gestation) were enrolled. Delivery outcomes and the indication for CS delivery were studied. RESULTS: The CS rate increased from 11.48% in 2009 to 14.76% in 2013 (p<0.05), and the perinatal mortality rate decreased from 3.34% in 2009 to 2.24% in 2013 (p<0.05). The 3 most common indications for CS delivery were previous lower segment CS, cephalopelvic disproportion, and intrauterine growth restriction. CONCLUSION: There is a trend of increasing CS rate at Hassan II Hospital. Previous lower segment CS, cephalopelvic disproportion, and intrauterine growth restriction are the 3 most common CS indications.