To study the associated factors for cesarean section (C-section) in a sample of pregnant women and to estimate its frequency at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia (KAMC-R). Methods: We studied 364 pregnant women who attended the Gynecology and Obstetrics Clinic at KAMC-R between March and June 2017. Results: Our 3-month study had higher rates of C-sections: women with older maternal age; (adjusted risk ratio [aRR]=1.08, p=0.001), lack of education (aRR=1.39, p=0.022), no personal history of vaginal delivery (aRR=1.85, p=0.001), undergoing C-section due to medical indications (aRR=2.28, p=0.001), and willing to repeat a C-section in the absence of medical indications (aRR=1.49, p=0.006). Cesarean section occurred in 27% of the total deliveries in 2016. Conclusion: Cesarean section are very frequent and prevalent in our center, and may be increasing. The frequency of C-sections was significantly higher for women of older maternal age, little education, no personal history of vaginal delivery, undergoing C-sections due to medical indications, and those willing to repeat a C-section in the absence of medical indications.