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In Egypt, the past decade has witnessed a sharp increase in the prevalence of cesarean section (CS) with the most recent Egypt Demographic and Health Survey documenting a CS rate of 52 percent, suggesting that cesarean delivery might be overused or used for inappropriate indications. This study aimed to explore trends, practices, and costs associated with CS deliveries to women, their families, and the health system, as well as factors that may contribute to increased use of CS in Egypt. Participating physicians and key informants unanimously agreed that the CS mode of delivery was over-used in Egypt. Perceived reasons underlying increased CS deliveries were: financial incentive, doctors’ desire to have better control over their time, doctors’ fear of medical litigation, vagueness of medical protocols regarding indications for use of CS, limited opportunities for junior doctors to practice vaginal deliveries, shortage of pain relief drugs in public hospitals, and shortage of anesthesiologists who are trained in administration of epidural anesthesia which could be used to relieve pain in vaginal deliveries. Recommendations are proposed for rationalizing the use of CS deliveries in Egypt