Background: Cesarean section significantly reduces maternal and prenatal mortality. The World Health Organization considers Cesarean section rates of 5 to 15% to be the optimal range for targeted provision of these life-saving interventions to mothers and infants. Cesarean Delivery in the second stage of labour in comparison to first stage is associated with a higher risk of complications, including unintentional extension of hysterotomy incisions and increased rates of bladder injury, blood transfusion, injury to the ureters and uterine atony. The risks to the neonate are also increased, with higher rates of admission to neonatal intensive care unit, sepsis. Even though many researchers showed possible maternal and fetal outcomes of second stage Cesarean section abroad, there is limited research done in the country and no study done in the study area. This study is important to assess fetomaternal outcomes and associated factors among second stage caesarean delivery women compared to first stage. Objective: The aims of this study is to assess the Fetomaternal Outcomes and Associated Factors among Second Stage Cesarean Delivery Women compared to first stage cesarean delivery at Public Hospitals in Bahir Dar City, North West Ethiopia Methods: A comparative cross-sectional study was conducted from January to March 2022, at public hospitals in Bahir Dar, Amhara Regional state, North West, Ethiopia by comparing 159 second stage group with 493 first stage groups taking 1:3 ratios respectively. The first chart from study populations was randomly selected using lottery method and the subsequent charts were selected by systematic random sampling method using sampling interval Sample size was allocated proportionally based on cases of each hospital. Checklist was used to retrieve information from the patient medical document. Pretest was conducted on 5% of population. The data was exported to Statistical Package for Social Science version 23 for analysis. Bi-variable and multivariable logistic regression analysis was computed to determine significant association. Results: Over all maternal complication of second stage group was 50.9% (95%CI=42.9-58.9) compared to 21.7% (95%CI=18.1-25.6) for first stage group. Among mothers who underwent Cesarean Delivery, about 90% were in age group 20-34. The overall neonatal complication of second stage group was 32% compared to 19% for first stage and most common fetal complication was early onset neonatal sepsis (23.2%). Maternal age and indication for surgery were found to be significantly associated with maternal complications. Conclusion and recommendation: The study revealed higher fetomaternal morbidities in second stage group. Therefore, utmost efforts should be made to avoid surgery. But if compelling situations are encountered due preparations for complication management should be made. Key words: Fetomaternal Outcomes, Associated Factors, First stage caesarean delivery, Second stage caesarean delivery and Women