Abstract: Background: Caesarean section (CS) is a potentially lifesaving obstetric procedure. However, there are concerns about the rising CS rate in many countries of the world including Kenya. The Ten-Group Robson classification system is presently recommended as an effective monitoring tool for comparing CS rates and identifying target groups for intervention aimed at reducing the rates. The aim of this study was to evaluate the caesarean section rate and the groups with the highest risk of CS at Nyahururu County Teaching and Referral Hospital (NTRH), using the Robson classification system.