Abstract: Background and Objective: Caesarean section is considered as the most common obstetrical operation worldwide. The ultrasonography-aided assessment of the lower uterine segment scar is crucial in determining the time of the next cesarean section. The present study aims to determine the optimal time of the next cesarean section according to gestational age and lower uterine segment thickness measured by transabdominal ultrasound. Methodology: Three hundred pregnant women were enrolled in a prospective follow up study at Al-Elweyia Maternity Teaching Hospital/Baghdad/Iraq from January, 2016-January, 2017 with two or more cesarean sections, all assessed for lower uterine segment thickness at term by ultrasonography and followed up for one month after labor. Results: The lower uterine segment thickness was significantly associated with the earlier gestational age of the pregnant women (p = 0.01), dehiscent uterine scar (p<0.001), low APGAR score (p<0.001) and low birth weight of neonates (p = 0.006). The lower uterine segment thickness cutoff value in predicting dehiscent scar was 3.9 mm (78.2% sensitivity and 82.3% specificity); while it was 3.9 mm in predicting shorter gestational age but with lower validity scores (69% sensitivity and 50% specificity). Conclusion: The lower uterine segment thickness can be considered as an appropriate predictor of dehiscent scars and shorter gestational age of pregnant women with previous two or more cesarean section in subsequent pregnancies.