In the recent decades, the high rate of cesarean section is increased worldwide along with critical concerns about its primary benefits. Many researchers showed the positive relationship between socioeconomic status (SES) and the prevalence of cesarean delivery. However, it seems that the prevalence of elective cesarean section is even rising in low socioeconomic classes.. The aim of this study was to evaluate the relationship between the socioeconomic status and the prevalence of elective cesarean section in nulliparous women in Niknafs Teaching Centre, in Rafsanjan, Iran..Patients and This cross-sectional study was comprised of 459 nulliparous women and was carried out in Niknafs Teaching Center, in Rafsanjan from August 2011 to April 2012. A valid questionnaire was completed during a brief interview with the subjects. It included the demographic, economic, and educational statuses of the subjects as well as information about the delivery types. The collected data was analyzed using chi-square and Fisher exact tests in SPSS version 16.. Five socioeconomic groups were defined as very poor, poor, fair, good, and very good. Overall, 74% of the participants were placed in fair and lower groups. Significant relationships were observed between SES and primary elective cesarean delivery (P < 0.001) as well as the final rate of cesarean delivery (P = 0.02). However, there was no statistically significant relationship between the reason for cesarean delivery and SES of the mothers.. The improvement of the SES has a linear relationship with demand for cesarean delivery. But elective cesarean section is notably high in Iran even in lower socioeconomic classes. This could verify that socioeconomic factors are not the only reason for the high prevalence of cesarean delivery in Iran and that other factors are in fact responsible for this level of performance..