Background: This study compares maternal and neonatal outcomes of elective cesarean sections (C-sections) and vaginal deliveries among 100 patients at Saraswathi Institute of Medical Sciences, Hapur. Of the participants, 40 underwent elective C-sections, and 60 had vaginal deliveries. The study highlights differences in recovery times, complication rates, and neonatal health, emphasizing the need for individualized decision-making in choosing the mode of delivery. Aims and Objectives: The aim of this study is to compare the maternal and neonatal outcomes of elective cesarean sections and vaginal deliveries to determine the advantages and risks associated with each delivery method. 1. To evaluate maternal outcomes, including complication rates, recovery times, and satisfaction levels, for both elective cesarean sections and vaginal deliveries. 2. To assess neonatal outcomes, such as Apgar scores, respiratory complications, and birth injuries, associated with each mode of delivery. 3. To identify factors influencing maternal satisfaction with the chosen delivery method. 4. To provide evidence-based recommendations for selecting the most appropriate mode of delivery for different clinical scenarios Methodology: Study Design: Prospective observational study conducted from March 2024 to November 2024. Population: 100 pregnant women admitted for delivery at Saraswathi Institute of Medical Sciences. Results: 1. Elective C-section (n = 40): Higher rates of surgical complications (10% surgical site infections, 5% postoperative hemorrhage). Longer recovery time (average 4 days hospital stay, 6-8 weeks full recovery). 2. Vaginal Delivery (n = 60): Higher incidence of perineal trauma (25%) and postpartum hemorrhage (8%). Quicker recovery time (average 2 days hospital stay, 2-4 weeks full recovery). Neonatal Outcomes: 1. Elective C-section: 95% of neonates had Apgar scores ≥7 at 1 minute; 10% experienced transient tachypnea of the newborn (TTN). 2. Vaginal Delivery: 92% of neonates had Apgar scores ≥7 at 1 minute; 5% had minor birth injuries (e.g., bruising). Maternal Satisfaction: 1. Elective C-section: 80% satisfaction due to avoidance of labor pain; 20% dissatisfaction from prolonged recovery. 2. Vaginal Delivery: 85% satisfaction due to quicker recovery; 15% dissatisfaction due to labor pain or trauma. Conclusion: This study concludes that both elective C-sections and vaginal deliveries have distinct advantages and risks. The choice of delivery mode should be tailored to each patient, taking into account medical indications, maternal preferences, and potential outcomes. Vaginal delivery remains the preferred method for low-risk pregnancies, while elective C-sections are valuable in specific situations.