Background: C/D rates have been increasing steadily globally. The rising incidence has resulted in some pregnant women requesting it in absence of any medical indication particularly in the pregnant women with one previous C/D. Objectives: To investigate the factors associated with the preference of mode of delivery among pregnant women with one previous C/D at KCMC. Material and methods: A hospital based cross sectional descriptive study employing quantitative methods, conducted from September 2010 to May 2011 at KCMC. A structured questionnaire included both open and closed question was used for data collection. Results: Of 348 pregnant women with one previous C/D, 125 (35.9%) chose to deliver by C/D during the current pregnancy. There was significant association between preference for caesarean delivery as mode of delivery and marital status, level of education, occupation, insurance status, experience of vaginal delivery in previous pregnancies, gravidity, and number of live children (p<0.05). The majority of pregnant women, 228 (65.5%), had adequate knowledge on indications of C/D. The most commonly known indications for C/D were cephalopelvic disproportion (93.4%, n=325); cervical dystocia (76.4%, n=266) and malpresentations/malposition (71.3%, n=248). Majority of women had knowledge on at least two out of four indications of trial scar demonstrating adequate knowledge. The most commonly known indications were adequate pelvis (97.1%), cephalic presentation (79.6%), and previous scar without maternal condition (61.5%). Conclusion: The majority of the pregnant women in this study prefer V/D; experience of V/D was associated with preference of V/D, the factors associated with the preference of C/D were increase level of education, number of living child and Health insurance cover. The majority of pregnant women had adequate knowledge on indications of C/D and TOS. The majority mentioned no labor pain for long time and reduces unexplained fetal/neonatal deaths as the reasons for preferring caesarean mode of delivery.