The objective of this chapter is to introduce operative vaginal delivery. Operative vaginal delivery encompasses deliveries undertaken in the second stage of labor with any type of forceps or vacuum (ventouse). Vacuum delivery, in particular, is dependent upon maternal effort and therefore such deliveries are termed “vacuum-assisted”. Skill in operative vaginal delivery is an essential part of modern obstetric practice and safe, successful deliveries can reduce perinatal mortality and morbidity and avoid difficult and risky cesarean sections. Decision making and prerequisites, pudendal nerve block—transvaginal technique, vacuum-assisted delivery, obstetric forceps, forceps delivery for the occipitoanterior position, and Kjelland’s forceps delivery are some other important topics, which are given in this chapter. 69 well-colored clinical images are also presented in this chapter.