Introduction: Obstetric emergencies are a major cause of maternal and foetal morbidity and mortality, particularly in sub-Saharan Africa where healthcare resources are limited. Emergency caesarean sections, whilst life-saving, are often performed under adverse conditions, requiring appropriate anaesthetic management. Improvements in anaesthetic techniques, particularly regional anaesthesia, have helped to reduce complications, but disparities persist between low- and high-income countries. Patients and Methods: This was a retrospective descriptive and analytical study conducted over a six-month period (1 August 2024 to 31 January 2025) at the ‘Le Luxembourg’ Mother and Child University Hospital in Bamako. The study included all women who underwent an emergency caesarean section with anaesthetic management. The variables studied included sociodemographic characteristics, surgical indications, anaesthetic techniques, perioperative incidents, and maternal and foetal outcomes. Results: Of the 191 caesarean sections performed, 77 were emergency caesarean sections, representing a rate of 40.31%. The mean age of the patients was 27.85 years. The main indications were acute foetal distress (26%), dystocia (19.5%) and severe pre-eclampsia (14.2%). Spinal anaesthesia was the most commonly used technique (75%), compared with 25% for general anaesthesia. Intraoperative complications were dominated by arterial hypotension (10.38%), haemorrhagic shock (6.4%) and nausea/vomiting (7.89%). Admission to the intensive care unit was required in 18.20% of patients. Perioperative maternal mortality was 3.89%. Discussion: The high frequency of emergency caesarean sections observed in our study reflects the difficulties in accessing routine obstetric care and delays in management, which are common in sub-Saharan Africa. Despite the predominant use of spinal anesthesia in line with international recommendations, the continued high use of general anesthesia highlights the severity of clinica