Background: The birth process carries many risks for women during pregnancy, delivery, and the postpartum period. The delivery route choice is critical to the mother's and child's health. The increasing rate of CS worldwide is an alarming concern for public health and obstetricians.

Objective: To identify the frequencies and the determinants for the preferences of mode of delivery in urban and rural communities.

Methods: The study was a cross-sectional study carried out on 304 mothers attending vaccination sessions for the scheduled vaccines in the second and ninth months of child age at Said Primary Healthcare Center, and Shobar Primary Healthcare Unit in Al-Gharbia Governorate, Egypt. The data was collected by interviewing the mothers using a predesigned tested questionnaire.

Results: Regarding the preferred mode of delivery, CS were preferred by 40.2% and 15% of females in urban and rural communities. However, 83.6% were delivered by CS at the last pregnancy. Immediate contact with the baby, immediate breastfeeding, better care for the baby and hand no scar were the most significant determinants for VD. Being easier than VD and safer for the baby were the most significant determinants for CS. Urban residence, age >25 and living in a separate home, primiparity, no abortion, and previous CS delivery were the most significant determinants of delivery mode.

Conclusion: The frequency of CS was higher than VD. Urban residence, age group 25- and living in shared home were the most important determinants for CS.