In low- and middle-income nations, safe delivery is a key concern for the maternal and child health. In India, the percentage of C-section deliveries has been found unexpectedly in last 23 years, from 2.9% (NFSH-1) to 17.2% (NFSH-4) and reported in southern Indian states. This chapter tried to expose the prevalence and proximate determinants of cesarean delivery at childbirth orders among Indian women aged 15–49. Fourth round of National Family Health Survey was used where distribution of study participants, prevalence, and factors associated with cesarean section deliveries were investigated by applying descriptive statistics, bivariate analysis, and multivariable logistic regression. The study found mothers aged above 35 years are more inclined toward c-section (50.1%) at first birth than the last birth (3.5%). The difference in c-section delivery between at first and last birth order was acutely found among women belonging to higher education (40.6 vs. 17.3%) and the richest HHs quintile (39.3 vs. 13.7%). Women aged above 35 years were more likely to experience for cesarean delivery than young mothers of 15–24 years at first-order birth (OR: 1.7, CI: 1.5–1.9) and second-order birth (OR: 1.4, CI: 1.2–1.5). An evidence-based and community-focused strategy needs to be implemented to monitor the medical indications for all C-sections in public and private healthcare facilities to address the increasing cesarean section rates in India. Ultimately, integrated programs through public–private partnerships are required to minimize unnecessary C-section cases and improve the health of women and newborns.