Objectives Caesarean section (CS) conducted before labour (prelabour CS (PLCS)), compared with vaginal birth, may pose additional maternal and perinatal risks.

No multicountry analysis has examined PLCS in low-income and middle-income countries (LMICs).

This study assessed rates, risk factors and associations of PLCS with perinatal outcomes in LMICs.

Demographic and Health Surveys conducted between 2015 and 2018 in 26 LMICs (13 countries in Africa, 11 in Asia and 2 in the Americas).

Women aged 15–49 years with singleton term births.