Introduction: Globally, Cesarean section rates have surged, surpassing the World Health Organization's recommended 10-15%. In Chennai, India, high rates are particularly evident in private facilities, driven by demographic shifts, medical advancements, and socioeconomic factors. Objectives: To assess the indications for cesarean section, immediate neonatal complications among neonates born via cesarean section, relationship between cesarean section indications and immediate neonatal complications, and associate indications of cesarean section with selected socio-demographic variables. Methods: This quantitative study employed a descriptive design to examine indications for cesarean sections and immediate neonatal complications among 81 mothers at a Tertiary Care Center. Results: The most common indication was previous cesarean section (91.4%), followed by central placental previa (63%) and the third most common indication was contracted pelvis. (54.3%). The immediate neonatal complications included feeding difficulties (35.8%), meconium aspiration syndrome (30.9%) and Hyperbilirubinemia (19.8%). Common complications also include hypothermia (22.2%) and birth injuries (8.6%). The coefficient of correlation between indications and immediate neonatal complication is 0.574. This indicates a moderately positive correlation which was statistically significant. Occupation was found to be significantly associated with indications of cesarean section.