Background: Primary caesarean section(CS) in the multigravida means first CS done on a woman who had previously delivered vaginally at least once after the period of viability.1 Cesarean section was mainly evolved as a life saving procedure for both mother and fetus during difficult delivery.2With the passage of time there has been a change in the indications for cesarean section and there is worldwide increase in rate of both primary and repeat caesarean sections.3 Aims & objectives: The aims of this study were to study the indications and complications of primary cesarean in multiparous women. Materials & Methods: The present prospective observational study was conducted in Maternity Hospital, Department of Obstetrics and Gynecology SKIMS Srinagar on 150 patients over a period of 1 year. The patients included were all singleton and term multipara women undergoing primary caesarean. Primigravida, women with previous LSCS, twin pregnancies and women with scarred uterus were excluded from the study. Results: A total of 150 patients were enrolled in our study. The most common age group was 31-35 years (60.5%). 80% of the patients underwent emergency cesearean section and 30% had elective ceserean section. Majority of patients( 61.3%) were directly received in our labour room in labour without prior admission. 81% patients had medical co-morbidities. Most common indication for cesarean in our study was fetal distress accounting for 28.6% of the cases, followed by preeclampsia/eclampsia(15.3%). Most common intraoperative finding was meconium stained liquor(34.2%) followed by distended lower segment (25.7%). Intra operative complications were noted in 9.3% of cases, most common complications being PPH in 4% of cases. Post-operative morbidity was observed in 14.6% of cases which includes abdominal distension in 4.7% of cases, wound infection and fever in 2.6% of cases each, urinary tract infection in 2%, wound dehiscence 1.3%, DVT and psychosis in 0.7% of cases each. Conclusion: This study reemphasizes that there should be detailed antenatal counselling of the multigravida women regarding their diet, risk factors, family planning and regular hospital visits, so that anticipated complications can be prevented.