Objective This study aims to determine the incidence of episiotomy in Kasr Alainy OBGYN Hospital in Cairo, Egypt. Objectives include identifying factors influencing the incidence of episiotomy. Design This cross-sectional study was conducted between March 1, 2022 and June 30, 2022, to determine the incidence of episiotomy among vaginal deliveries in the hospital. Setting Data was collected from patient charts at Kasr Alainy OBGYN Hospital in Cairo, Egypt. Patient Sample The total number of patient charts inspected was 1731, of which 1545 met the inclusion criteria. Methods Data was manually collected from patient hospital records at the end of each day, and entered into a standardized data-collection form. The data collected was then statistically analyzed using SPSS. Main Outcome Measures The overall incidence of episiotomy was found to be 64%. Results The overall incidence of 64%, broken-down by gravidity, it was found that the incidence of episiotomy is 97% in primigravid patients, and 52% in multigravida patients. Several other associated factors were reviewed. Conclusions The incidence of episiotomy at Kasr Alainy OBGYN Hospital is greater than the WHO recommended rate. Further research is recommended to study the indications of episiotomy and collect information regarding how episiotomy affects patients’ perineal health and quality of life. This will aid in drawing evidence-based conclusions regarding the advantages and drawbacks of episiotomy, and how its incidence changes over time. Funding This research received no external funding. Keywords episiotomy; vaginal delivery; Egypt; Middle East; Africa; gravidity; maternal age; gestational age; cervical diameter; gestational weight