Introduction: The Apgar score is a practical method of systemically assessing newborn babyrnimmediately after birth to identify those requiring resuscitation and to predict survival inrnneonatal period. In spite of the growing number of newborns that are delivered via Cesareanrnsection, the decrease in Apgar score of babies delivered under cesarean has become one of thernconcerning issues.rnObjective: To assess the effects of general versus spinal anesthesia over Apgar score ofrnnewborns delivered by cesarean sections and factors associated with Apgar score from January tornMarch 2016 at Gandhi Memorial Hospital, Addis Ababa.rnMethod: Institutional based comparative cross sectional study design was conducted. Systematicrnrandom sampling technique was used to select study participants. Training was given for datarncollectors and supervisors. Regular supervision and follow up was made. Data was entered intornEpi info version 7 computer software by investigators and was transported to SPSS version 20rncomputer program for analysis. Bivariate and multivariate analysis was used to identify factorsrnassociated with Apgar score.rnResult: A total of 86 study subjects were included. Majority of baby had low Apgar score at onernminute and high Apgar score at five minute. Out of 43 mothers, who received spinal anesthesia,rn15 patients (34.88%) gave birth to neonates having Apgar score >7 at one minute. On the otherrnhand, out of 43 mothers who received general anesthesia, 7(16.3%) mothers gave birth tornneonate having Apgar score â‰¥7 at one minute. It had been found that those neonates who werernborn under general anesthesia were three folds more likely to have low Apgar score than thosernwho born under spinal anesthesia (AOR 2.768 (95% CI ((.876-8.745).rnConclusion and recommendation: There was relatively a low Apgar score among newbornrnbabies delivered under general anesthesia. Therefore, the use of spinal anesthesia wasrnrecommended.