Background: With a rate of 51.8%, caesarean section is the most frequent major surgical surgery in Egypt, putting Egypt in the third place with the highest CS rate, world widely. Objective: To assess if using povidone iodine in vaginal cleansing during elective cesarean section affect infectious morbidity. Methods: This prospective case control study was performed on 140 pregnant women scheduled to deliver with elective CS aged 20 -35 years old. Women were split equally into 2 groups; group (I): included pregnant women receiving vaginal cleansing prior to cesarean section and group (II): included pregnant women receiving routine care as a control group (standard care). All included cases were subjected to full history taking, general, abdominal and local examination. All patients received preoperative antibiotic according to our department protocol just before skin incision. Results: Our findings reported that 4 (5.71%) patients in group I and 15 (21.43%) patients in group II had fever, 3 (4.29%) patients in group I and 13 (18.57%) patients in group II had endometritis, and 2 (2.86%) patients in group I and 10 (14.29%) patients in group II had wound infection, revealing significantly higher fever incidence, wound infection and endometritis in group II compared to group I (P=0.012, 0.014, and 0.03 respectively). Incidence of allergy or irritation was insignificantly different between the studied groups (P> 0.097). Conclusions: Using povidone iodine as a vaginal cleansing instantly prior elective CS substantially decreases post-CS endometritis, wound infection and fever rates