Abstract: Objective To analyze the changes in cesarean section rate and its indication in recent 5 years (from 2008 to 2012), then providing evidence for intervention measures. Methods Retrospective analysis of recent 5 years was done for Minhang District maternity and infant quarterly statements and cesarean section clinical data.Results The rate of cesarean section still showed an upward trend, and vaginal birth rate declined year by year. The cesarean section rate of Shanghai census register was significantly higher than that of non Shanghai registration, but the gap was smaller and smaller. The first 4 indications for cesarean section were fetal distress, cephalopelvic disproportion, scar uterus, and social factors. Scar uterus increased year by year, and in 2012 rose to the first one. Fetal distress, cephalopelvic disproportion decreased year by year, and social factors had no obvious change. Conclusion The main reasons for the high rate of cesarean section were social factors, medical factors, economic factors and others. Comprehensive intervention measures should be taken actively for controlling the cesarean section rate in the reasonable scope.