Background: Currently, cesarean delivery is dramatically increased obstetric procedure worldrnwidely, but it associated with postoperative pain. â€œPostoperative pain is a sensory and emotionalrnexperience associated with actual or potential tissue damageâ€. Understanding risk factors of painrnreduce social, economic, health, and psychological impact on mothers and family. rnObjective: To assess the incidence and risk factors of postoperative pain after cesareans sectionrnwithin the first zero, six, and 12 postoperative hours among the pregnant mothers taking spinalrnanesthesia at Gandhi women and child care memorial hospital, Addis Ababa, Ethiopia 2020/21. rnMethods: After ethical committee approval, a cross-sectional study was conducted on 384rnparturients who undergo cesarean section under spinal anesthesia in GMH in 2020/21 G.C.rnSample size was calculated by single population proportion formula by taking 39% of thernprevious study done from Uganda 2015. Data were collected by a structured questionnaire. SPSSrnversion 24 was used for data entry and analysis. Binary logistic regression was applied forrnanalysis. A p-value of < 0.05 was considered statistically significant. rnResult: The incidence of postoperative moderate to severe pain after cesarean section underrnspinal anesthesia was 47.4%. Duration of surgery, length of skin incision, and adjuvant added inrnbupivacaine, preoperative patient pain, preoperative anxiety, nerve block done at end of thernsurgery, and type of incision had a strong association with moderate to severe pain. rnConclusion: Postoperative pain after spinal anesthesia at Gandhi women and child carernmemorial hospital was high and needs pain management practice improvement. The practice ofrnadding adjuvant to a spinal local anesthetic agent and performing nerve block at the end of thernprocedure were significantly reduced the experience of postoperative pain.