Background: A cesarean section is the most common obstetric surgery performed today. Evenrnthough cesarean delivery is the safest mode of delivery for high risk situation, it also appears tornhave higher risk of maternal and neonatal morbidity and mortality than vaginal delivery in lowrnrisk cases. rnObjectives: To determine the maternal and fetal health outcome after cesarean section and itsrnassociated factors in Gurage Zone governmental hospitals, SNNPR, Ethiopia 2021 G.C. rnMethods: Institutional based retrospective cross-sectional study was conducted in Gurage Zonerngovernmental hospitals from February 21/2021- March 13/2021on cards of mother whorndelivered by cesarean section from February 2019 to January 2021. The total sample size wasrn398 and collected from five governmental hospitals. The collected data was entered and analyzedrnusing STATA version 15. Binary and Multiple Logistic regressions were used to identifyrnassociated factors for maternal outcome and fetal outcome. rnResult: Out of mothers included in the study 23.4% of them had poor maternal outcome. Thernprevalence of poor fetal outcome was 19.74%. Obstetric complication [AOR of 2.65, 95% CI,rn(1.17, 6.01)], Medical disease [AOR of 3.39, 95% CI (1.13, 10.16)], General Anesthesia [AORrnof 16.8, 95% CI (1.32, 212.54)] and Ante Partum Hemorrhage as indication for Cesarean Sectionrn[AOR of 3.73, 95% CI, (1.08, 12.83)] are found to be statistically significant factors for poorrnmaternal outcome. Also Medical disease [AOR of 5.78, 95% CI (1.17, 28.54)] and CephalicrnPelvic Disproportion as an indication for Cesarean Section [AOR of 5.57, 95% CI (1.74, 17.78)]rnare statistically significant factors for poor fetal outcome. rnConclusion & Recommendation: The prevalence of poor maternal and fetal outcome is 23.37%rnand 19.74% respectively. The most common maternal complications post CS were infectionrn(5.98%), Blood transfusion (5.71%), Hemorrhage (5.43%). Although much emphasis has beenrnplaced on reducing maternal mortality associated with pregnancy, mothers who escapernpregnancy-related mortality but suffer health consequences should also be given specialrnattention.