Cesarean section is a life-saving procedure that saves the life of mother and fetus. World Health organization has recommended a threshold rate of 15% caesarean section. It is a major healthcare issues now in all over the world and rising cesarean delivery rate higher than the optimal both in developed and developing countries. The main objective of this study is to assess the trends and magnitude of cesarean section. The study was carried out in one of the regional hospital in Western Nepal. It was the hospital based retrospective review that used the three years record information from data registry of maternity, gynae, operation theater, NICU of regional hospital. The prepared retrospective guidelines were used to collect the demographic, obstetrics and outcome variables of the study. The study analyzed the three years retrospective review of fiscal year 2070 – 2073. The overall magnitude of the cesarean section was 24.25%. The rate of Cesarean section was 23.91, 26.51 and 22.78 percent in the fiscal year 2070/71, 2071/71 and 2072/73 respectively. The study concludes that cesarean section rate was higher than WHO recommendation of particular regional hospital of Western Nepal. The trends of cesarean section seem rising in the year by Year