When fetus assumes a position other than the normal longitudinal lie with vertex presentation in a flexed attitude in labor, it is called malpresentation and occurs in 3-5% of cases. The commonest malpresentation is breech presentation. Other malpresentations are the transverse and oblique lie, the face and, brow presentations and the compound presentation. Brow and compound presentations are the least common. Predisposing factors for malpresentations are uterine abnormalities or space occupying lesions, site of placental insertion, multigravida with lax abdominal wall, contracted pelvic inlet, congenital malformations of the fetus and amniotic fluid abnormalities and multiple pregnancies. The first step in the management of malpresentation is its correct diagnosis as it is likely to impact labor adversely. A good history, clinical examination of the abdomen and pelvis and imaging techniques like ultrasound helps in correct diagnosis of the type of malpresentation. Primary cesarean section is indicated in compound presentation if there is associated prolapse of cord or nonreassuring fetal heart is present. Breech presentation in the antenatal period or early labor should be corrected by ECV. Elective cesarean section for breech presentation is indicated for footling breech presentation, hyperextended head, low birth weight breech, large fetus more than 3.5 kg, any degree of contracted pelvis or unfavorable shape of the pelvis, associated medical conditions, postdated pregnancy and non-reassuring fetal heart rate. Transverse lie in antenatal period should be corrected by external version, if there is no contraindication to it from 34 weeks of gestation onwards. If ECV fails or is contraindicated, elective LSCS should be done at term.