Background: The primary objective of the present study is to determine the episiotomy rate and factors associated with practice of episiotomy at the maternities in Bukavu town, South-Kivu, DRC.Methods: A case-control study was carried out the women who underwent the episiotomy (case) and those which did not undergo episiotomy (control) over one 12 months period between January to December 2015. A total of 1878 women had a vaginal delivery at a rate of one case for one control (939 cases and 939 controls) were included. Their medical files were exploited. The factors associated with episiotomy were performed by logistic regression.Results: The rate of episiotomy was 20.4%. It was found that after the logistic regression, the Primiparity (OR = 4,5;95% CI:2,31-4,49), the existence of a foetal distress (OR = 4,2;IC to 95% CI :2,36-5,29), the antecedent of episiotomy (OR = 3,9;95% CI:2,83-7,07), private character of maternity (OR= 3,3; 95% CI :2,12-6,30) and the fact that the childbirth was directed by a doctor (OR = 2,3; 95% CI :1,85-5,08) were strongly associated with the practice of the episiotomy in our medium of study.Conclusions: This study showed UA-S/D ratio and UA-RI>2SD are significant predictors of perinatal deaths and immediate neonatal resuscitation in preeclampsia. Acute fetal distress in labour or neonatal nursery admission could not be predicted.