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Introduction: In India, the lower segment Caesarean section rate, according to the National Family Health Survey-5, ranges from 17% to 21.5%. Second-stage Caesarean rates are 2.3%. Prolonged labor in the first stage can cause the fetal head to wedge deep into the pelvis, leading to an obstetric emergency called an impacted fetal head. In the UK, about 1.5% of unplanned Caesareans involve an impacted fetal head. This condition has significant maternal and neonatal risks. Aims and objectives: 1. Assess the maternal & neonatal outcome in cases of impacted foetal head 2. Assess the technique used to deliver the head 3. Assess the decision to delivery time Materials and methods: A retro-prospective observational study conducted in the department of Obstetrics and Gynaecology, LTMMC and LTMGH. Sample size was 30. Results: The study included 30 women, with an average age of 25.5 years; 60% were primigravida. Labor was induced in 56.7%, and oxytocin augmentation was used in 46.7%, with an average initiation time of 3 hours. The fetal head station ranged from 0 to +2. Caesareans were performed by obstetricians with over 3 years of experience in 60% of cases, primarily using the Patwardhan method. Maternal complications included uterine incision extensions (43%) and blood transfusions (2.3%), with 1.3% requiring surgical ICU admission. Among neonates, 31% required NICU admission, including one stillbirth. Non-invasive and invasive ventilation were needed in 23.3% and 6.6% of cases, respectively, with an average Downes score of 6/10. Induction of labor & oxytocin use were not significantly associated with NICU admissions (p = 0.47 and p = 0.52, respectively). Conclusion: During caesarean for impacted head , senior input & coordination with anesthetists & neonatologists are vital. Clear guidelines on techniques like the Patwardhan or push method are needed to enhance outcomes