Aim: To compare the effect of rectus muscle and peritoneum closure versus non closure during repeated Cesarean Section on postoperative pain. Study Design: A prospective, single-blinded, randomized clinical trial. Patients and Methods: It included 100 patients, who, underwent repeated Cesarean section. They were randomly allocated into two groups; group A & B with nonclosure & closure of rectus muscle and peritoneum respectively. Postoperative pain was assessed by visual analogue scale during hospital stay. Postoperative analgesia, amount of blood loss and occurrence of postoperative complications were also analyzed. Results: Women with non-closure technique had significantly lower visual analogue score (VAS) at the end of 1st 48 hours postoperative (2.86 ± 1.61) in comparison to other group. Women who underwent closure had no difference as regard VAS (4.26 ± 2.19 vs. 4.80 ± 2.36; p value = 0.19). Regarding postoperative analgesia intake, women with non-closure had a significant lower intake of analgesic drugs (170.76 ± 30.85 mg) in comparison to the other group. Conclusion: Rectus muscle and peritoneal approximation is associated with significant increase in postoperative pain and analgesia.