BACKGROUND: Monitoring the time interval from decision to operate to delivery of fetus for emergency caesarean section, is an important method of auditing the effectiveness of an obstetric unit. OBJECTIVES: To determine the decision to delivery interval for emergency Caesarean sections at Aminu Kano Teaching Hospital and the impact on fetomaternal outcome. METHODOLOGY: It is a prospective cohort study, where questionnaires were administered on 350 patients booked for emergency caesarean section before and at the end of the procedure, at Aminu Kano Teaching Hospital.