The rate of cesarean deliveries has increased over a decade due to multifactorial reasons explicitly; decrease in vaginal births after cesarean (VBAC), multiple gestation, maternal obesity, pre-term labor, gestational diabetes or hypertension, increased number of high-risk expectant mothers and the obstetrical medico-legal environment. Delivery of the fetal head at the cesarean section can sometimes be a cumbersome procedure and may result in maternal or fetal complications. The fetal vacuum extractor enables traction to be applied to the fetal head, in the birth canal, by means of a suction cup that is powered by an external vacuum source. To investigate the benefits and limitations of soft cup vacuum extractor on the fetal scalp during the cesarean section. This study was conducted on 88 full term pregnant women undergoing cesarean section at Nepalgunj Medical College and Teaching Hospital, Nepalgunj, Nepal. All patients were between 37 and 41 weeks of pregnancy with signs of healthy fetus and were divided into 2 groups; Group A- 42 patients subjected to vacuum extraction at the cesarean section, Group B- 46 patients subjected to the conventional cesarean method. The interval between the final uterine incision and complete delivery (U-D interval) and the Apgar score at 1 and 5 minutes after birth were evaluated. The data was statistically analyzed. In Group A, 24 (57.1%) women out of 42 and in Group B, 26 (56.5%) out of 46 were primagravida. Nine (21.4%) out of 42 women in Group A and 13 (28.3%) out of 46 women in Group B had a previous history of cesarean section. Lateral extension in uterine incisions was seen in 3 cases (7.1%) in Group A and 6 cases (13.0%) in Group B. The duration of scalp traction for Group A and Group B subjects were 32±3 sec and 48±16 sec respectively. The birth weight of the babies delivered in Group A and Group B were 3.08±0.47 and 3.07±0.46 respectively. The gestational age of the babies in Group A and B were 39.1±1.09 and 38.9±1.10 weeks. The initial Apgar score for Group A and Group B were 5.67±1 and 5.83±1.20. U-D interval for Group A and Group B were 75.6±9.02 and 43.5±8.6 respectively. It was found that the use of vacuum extractor is an easy, non traumatic and rapid method which abates the need of rough and prolonged fundal compression and its consequences and significantly fewer maternal complications