OBJECTIVES:  Rates of caesarean section increased steadily since the late 1990s in China. To estimate the recent trend of caesarean section and its correlates from 2008 to 2014 in Xindu County of Chengdu, China. METHODS:  We extracted birth records for all births regarding delivery methods and maternal characteristics from Chengdu Municipal Maternal and Child Health Management System in 2008-2014. Chi square test was used to analyze the change of caesarean section rates over the period of study. Univariable and multivariable logistic regression models were used to assess the demographic, obstetric, and neonatal factors that correlated with the prevalence of caesarean section. RESULTS:  The analyses, based on data for 51580 singleton live births, showed that the rate of caesarean section was 56.90% in 2008, and after a transient rise declined to 51.97% in 2014 (Ptrend <0.001). The rate of caesarean section in pregnant women who delivered at a tertiary hospital was 3.52 times [95% confidence intervals (CI): 3.15-3.92] that in those who delivered at a community health center. Pregnant women who were older than 35 years old [odds ratio (OR): 2.08; 95% CI: 1.82-2.37] and had high-risk pregnancy (OR: 1.88; 95% CI: 1.81-1.97) were more likely to have a caesarean section compared with their counterparts. Primipara women had a higher rate (OR: 1.29; 95% CI: 1.22-1.35) of caesarean section than multipara women. Women having a large for gestational age neonate were 1.77 times (95% CI: 1.58-1.99) more likely to have a caesarean section compared with women having a small for gestational age neonate. Local residents were 1.44 times (95% CI: 1.31-1.58) more likely to have a caesarean section than internal migrants with a short stay. CONCLUSIONS:  Caesarean section rates show a decreasing trend in Xindu of Chengdu. Factors that correlate with caesarean sections may help establish targeted antenatal services and obstetric care.