Background: Caesarean section rates are rising with possible negative impact on mother and baby. Methods: This was a prospective, case control study that was conducted in Omdurman maternity hospital during the period July 2013 to January 2014. 400 babies were included in the study, 200 were outcome of normal spontaneous vaginal delivery and the other 200 were outcome of elective caesarian section. Data was collected using a specifically designed questionnaire containing maternal and neonatal data, Neonatal outcome was compared between the two groups.. Data was analyzed by SPSS program, Chi square test was used to study the correlation between neonatal outcome and type of delivery. Results: The results showed that the majority of the women in the caesarean section group (87%) had regular antenatal care. There were 4(2%) babies with low birth weight (LBW) in the vaginal delivery group compared to no baby in the other group. There were 7(3.5%) babies in the vaginal delivery group with Apgar score less than 7 at 5 minutes and no baby in the caesarian section group had low Apgar score with significant association between low Apgar score and type of delivery (P=0.001).Elective caesarean delivery increased the rate of transfer to the neonatal intensive care unit and the risk for transient tachypnea of the newborn with significant association between transient tachypnea of the newborn and type of delivery (P= 0.04). Conclusion: There is an association between mode of delivery and neonatal outcome. Therefore, we emphasize the importance of limiting elective caesarean deliveries to cases with clear indications and proven benefit for the mother and baby.