The study aimed to explore antenatal women’s awareness and perception of caesarian section attending an urban hospital in the Gambia. The study used a qualitative exploratory research design. A purposive sample of 47 antenatal women was selected at the antenatal clinic (ANC) and the data collection tool was a structured interview guide with open ended questions which was developed by the researchers. Data were collected using face-to-face in-depth interviews and focus group discussions.