Purpose: The continued rise in caesarean section deliveries (CS) raises a major public health concern worldwide; our aim is to evaluate trends and determinants this increase, comparing indications between 1997 and 1998 (group A) and 2015 and 2016 (group B). Materials and Methods: A retrospective study was conducted at Jordan University Hospital analyzing all indications of CSs. Each delivery was assigned to the primary indication noted for that pregnancy. Results: The CS rate gradually rose from 22% in group A to 62%, and to 65% in group B. The leading indications for the increase rate of CS across the years were previous ≥ 2 CS, followed by decreasing rate of trial of previous uterine scar, non-reassuring fetal heart pattern, breech presentation, twin pregnancies, obstructed labor, and placenta previa. Conclusion: CS rates increased over the last 20 years. The appropriate way is to deal with this trend, is to reduce the primary section.