This paper analyzes Apgar score associated with mode of delivery for live births in São Paulo State, Brazil, 2003. Based on data from the State Data Analysis System Foundation (SEADE), logistic regression was analyzed for live births with low Apgar score (0 to 6) at the fifth minute of life per mode of delivery, adjusted for obstetric, demographic, and social factors. Birth weight, gestational age at delivery, number of prenatal visits, maternal age, marital status, and years of schooling were statistically significant, and (as expected) all exposure categories were associated with low Apgar score. In the unadjusted model, the odds ratio (OR) for low Apgar was 0.890 (95%CI: 0.836-0.948) for cesarean section compared to vaginal delivery. Nevertheless, in the adjusted model the OR was 1.045 (95%CI: 0.977-1.117) for cesarean section compared to vaginal delivery. Adjusted for obstetric, demographic, and social factors, mode of delivery was not statistically significant for low Apgar.