Objectives: Identify and demonstrate the burden of low birth weight (LBW) in neonates born by emergency and elective cesarean section. To determine if delivery type had any effect on low birth weight (LBW) rates, associated variables were needed to determine the rate, such as the gestational age, placental weight, admission to the NICU, Apgar scores and maternal BMI. Methods: In the present retrospective cross-sectional study 335 cesarean deliveries were performed at Maternity and Children Hospital, Najran. Neonates were classified by type of cesarean section: elective or emergency. LBW was defined as birth weight <2500 grams. Chi-square tests analyzed bivariate relationships, while logistic regression reported independent predictors. Interaction effects of cesarean type with PROM were also examined. Interpretations were expanded using visualizations such as a forest plot, scatter and an ROC curve. Results: The incidence of low birth weight (LBW) was significantly higher in emergency CS than in elective CS (17.9% vs 8.3%, p = 0.038). Emergency CS was still an independent predictor (AOR = 2.08, p = 0.043), and low Apgar score <8 (AOR = 2.95), NICU admission (AOR = 2.62) and placental weight <400g (AOR = 3.91). The interaction between Emergency CS and PROM increased the risk of LBW (AOR = 2.67). Our last prediction model had meaningful prediction fit (AUC = 0.82). Conclusion: Emergency cesarean section was associated with increased risk of LBW when PROM & placental insufficiency were present. These results emphasize the significance of early risk stratification of prenatal disorders, obstetric anticipatory care and preventive interventions to improve neonatal outcomes.