Background: The contraceptive methods that are offered to a woman with previous cesarean section are either tubectomy at the time of aesarean section or contraception at a later postnatal visit. Transcesarean Intrauterine contraceptive device placement gives an opportunity to provide a long-term, reversible and cheap contraception with minimal side effects. It has no interference with lactation and also helps in spacing. Aims and Objectives: The primary objective was to study about the acceptability of IUCD as a choice for Transcesarean contraception among women undergoing repeat cesarean section and the influence of sociodemographic factors on their choice; the other objectives were to calculate the uptake of transcesarean IUCD in these patients and to evaluate its safety Method: Prospective cohort study conducted in Department of Obstetrics and Gynecology at Apollo institute of medical sciences and research, Hyderabad, India with 200 women with previous one cesarean section. They were counselled regarding various methods of contraception and the option of Transcesarean IUCD insertion also was discussed. Their choices along with factors such as age, education, religion, previous child age, reasons for nonacceptance were noted in the form of a questionnaire. After placement of IUCD, they were observed for any side effects during immediate postoperative period, at the time of discharge and at 6 weeks postpartum. Results: The acceptability of Transcesarean IUCD is Original Research Article 34% while Tubectomy is 29%. IUCD is preferred over Tubectomy among women in age group of 20–25, educated couples who have previous female child and are planning spacing. 37.8% do not prefer IUCD due to its side effects. Expulsion rate of Transcesarean IUCD is 2.9% at one week and 10% at 6 weeks after insertion. Conclusion: Acceptability of Transcesarean IUCD is low due to various social factors and also due to fear of side effects. These barriers can be overcome by regular antenatal counseling so that its uptake increases and unmet needs of family planning can be met.