Worldwide, not only is cesarean section (CS) the most commonly performed major surgery, but it is also the commonest obstetric operation. CD is associated with some chronic maternal morbidities including pelvic pain, adhesions and adverse reproductive effects. CS carries long-term sequele which can adversely affect subsequent pregnancies. Why do some women develop bad sequele of CS-like adhesions, and infertility is well demonstrated in this chapter. Fertility-oriented step-by-step description of CS techniques is extensively described. Some recent controversial issues related to CS like the development of uterine nitche (isthmocele) at the CS scar site, placenta accrete and the role of cesarean myomectomy are discussed in details. At the end of this chapter, the reader will conceive enjoy fertility-oriented concept of CS.