Background Auditing the CS according to a standard criterion will lead to avoid many complications. Clinical audit is a tool to improve quality of care and to reduce maternal and perinatal morbidity and mortality. Objective: to evaluate the current practice and audit against international standards for various parameters relating to elective lower segment caesarean section and to assess compliance of physicians to audit standards. Design: A cross-sectional study. Setting: New Mowasat Hospital in Kuwait from 1st October 2018 until 1st October 2019. Sample: Three hundred and twenty six (326) cases of elective caesarean sections. Methods: The hospital medical, electronic records and case notes were reviewed for study participants. Those women were booked under the care of internal and external physicians. Demographic data and primary outcomes were collected. Outcome: measuring the compliance to the recognized Caesarean Section international standards: consent form, grade of LSCS, antacid and anti-emetics, type of anesthesia, uses of antibiotics, umbilical cord blood PH, and thrombopropylaxis. Results: compliance for a signed consent form (100%) ,cord blood PH(100%),use of preoperative antacid and antiemetic (99.4%) , combined regional anesthesia(53.4%), second generation cephalosporin(61.3%) , thrombopophylaxis ( 78.5 %)of which (33.6%) completed a 10 days duration . There was a statistically significant difference between internal and external physicians compliance regarding, type of anesthesia 2.3 (95%CI, 1.3-4.1p=0.004), type and timing of antibiotics 0.42(95%CI 0.22-0.79, p=0.007) and 0.33 (95%CI 0.172-0.63, p=0.0006) and thrombopophylaxis 8.1 (95%CI 2.80-23.23, p=0.000). Conclusion: the results are encouraging, but suboptimal compliance was noticed mainly among external physicians. Funding: None