Caesarean section is one of the oldest surgical procedures in recorded history, with origins that blend mythology, religion, and early medical practice. The term “caesarean” is often linked to Julius Caesar, although there is no historical evidence that he was born this way. Instead, the name likely derives from the Latin lex caesarea, a law requiring the removal of a fetus from a deceased pregnant woman before burial. In antiquity, caesarean sections were almost exclusively performed post-mortem, as the procedure was nearly always fatal for the mother due to haemorrhage and infection. Early references appear in ancient Hindu, Egyptian, Greek, and Roman texts, but survival of the mother was exceedingly rare. The first documented case of a woman surviving a caesarean section is often attributed to Jakob Nufer in the 16th century. According to accounts, he performed the operation on his wife after prolonged obstructed labour, and both mother and child survived. While debated, this case marks a turning point in the perception of the procedure. Progress remained slow until the 19th century, when advances in anaesthesia, antisepsis, and surgical technique transformed outcomes. The introduction of ether and chloroform allowed operations to be performed with reduced pain, while Joseph Lister’s work on antisepsis significantly reduced infection rates. Surgical innovations, such as uterine suturing techniques introduced by Max Sänger, further improved maternal survival. In the 20th and 21st centuries, caesarean section has become a common and generally safe procedure. Indications have expanded beyond life-saving emergencies to include elective and planned deliveries. Despite this, it remains major abdominal surgery, with ongoing discussions about appropriate use and rising global rates. Today, caesarean section is a cornerstone of modern obstetrics, reflecting centuries of surgical evolution and advances in maternal care. Rate This Article