The main concern of this chapter is to present breech presentation. Breech presentation is the most common malpresentation and is found in 3–4% of full-term singleton pregnancies. Although prematurity and multiple pregnancies are the main known causes, chance alone is responsible for most of the cases. Other causes include placenta previa, congenital uterine malformation such as septate or bicornuate uterus, the presence of uterine fibroids or fetal abnormality. The relationship between the position of the baby’s lower extremities and buttocks forms the basis for the description of the three types of breech presentation—the frank or extended, the complete or flexed, and the incomplete or footling. Optimal mode of delivery, external cephalic version, vaginal delivery of the breech baby, management of the second stage of labor, Pinard’s maneuver, Lovset’s maneuver, and delivery of the fetal head and cephalic complications are also discussed in this chapter.