BACKGROUND: Many reports claim that propofol anesthesia in cesarean section is safe for neonates, but these studies concern cases of elective, or combined elective and emergency surgery. Our study was designed to investigate the effects of propofol on neonates in emergency cesarean section. METHODS: One-hundred patients for cesarean section were involved. They were divided into 2 main groups; (P) anesthesia with propofol (N = 50) and (E) enflurane (N = 50). Both P and E were subdivided into 2 groups each; (PE) propofol elective (N = 25); (EE) enflurane elective (N = 25); and 2 emergency subgroups, (PM) propofol emergency (N=25), and (EM) enflurane emergency (N = 25). Apgar score (1 min, 5 min), Neurologic Adaptive Capacity Score (NACS, 15 min, 24 hr), cord blood gas analysis (cBGA) were measured. Maternal venous and umbilical artery and venous blood concentration of propofol were measured at delivery. RESULTS: The values of the Apgar score, NACS, and cBGA of group P were not different from the corresponding values of group E. Also there were no differences between groups PM and EM, and between groups PE and EE. The blood concentration of propofol was 2.36 microgram/ml in the maternal vein, 1.13 microgram/ml in the umbilical vein, and 0.89 microgram/ml in the umbilical artery. CONCLUSIONS: From these results, it may be suggested that propofol is safe for neonates in emergency cesarean section surgery.