Increased cesarean rate has been observed in both developing and developed countries, including India. Cesarean rates are much higher than the recommended level of 5–15%. With emerging evidences, trial of labor after cesarean section (TOLAC) is an acceptable current practice. “Once a cesarean always a cesarean” was a dictum of management of pregnancies with previous cesarean. Important points to be noted while taking history in a case of previous cesarean section (CS) are previous obstetric history, number of previous pregnancies, mode of delivery in the previous pregnancies, previous records to be asked for and details are to be recorded, any history of any abortion, if yes whether dilatation and evacuation was done or not, any previous vaginal delivery—prior to CS or vaginal birth after CS (VBAC). The chapter also covers antenatal counseling, suitable criteria and contraindications for VBAC, predictors of VBAC success or failure, components for VBAC score, predictors of uterine rupture, signs and symptoms of uterine rupture and management, and preoperative requirements for elective repeat cesarean section, amongst many others.