Cesarean section is most frequent „major“ instrumental-manual operation on women arround the world. The aim of this study is to present the data on the frequency of Cessarean section in the maternity ward of the Virovitica General Hospital in the 20 years period from 1998. to 2017. and compare them with the data of other maternity wards at the level of the Republic of Croatia, as well as to determine whether the increase in the frequency of the cessarean section had a positive effect on reduction of perinatal mortality. The data was collected from the annual reports and birth protocols of the Virovitica General Hospital. In addition to these data, data from the reports on births in health institutions in the Republic of Croatia, the Croatian Institute of Public Health and annual reports on perinatal mortality of perinatal counseling were used for the same period. In that period, a total of 16006 births were performed in the maternity hospital of Virovitica General Hospital. During the twenty-year period, there were altogether 3133 cessarean sections, which averaged 19.6% of the total number of births annually. There is also a continuous increase in the frequency of the cessarean section in the stated period, so its frequency has been doubled. During the period, there has been a constant trend in the increase in the frequency of the cessarean section in Croatian maternity wards, and its higher frequency in the maternity hospital of the General Hospital of Virovitica compared to the average in Republic of Croatia throughout the period. Another goal was to determine whether the double increase in the frequency of the cessarean section in our maternity clinic had a positive effect on the reduction of perinatal mortality and the reduction of early neonatal mortality, what is considered to be one of the most important reasons for the increase of operational childbirth completion. The positive effect of increasing the incidence of births completed by Caesarean section on reduction of perinatal mortality was found, according to our data.