There has been a decline in operative vaginal delivery worldâwide. Vacuum extraction has largely replaced forceps delivery in our low resource setting and in the developed countries, but the teaching and exposure of this procedure is still on the decline. There is a need for enhanced teaching and exposure of operative vaginal delivery and mastering of the procedure in our centers by the residents in training. Review of the pertinent literature and studies on operative vaginal delivery, selected references, internet services on operative vaginal delivery. Earlier studies on operative vaginal delivery showed that vacuum extraction has been the procedure of choice. The rates reported from developed countries were much higher than the rates reported from Nigeria. Vacuum extraction rates of 1.5% from Zaria, 1.7% from Maiduguri, 1.6% from Ilorin and 3.5% from Benin City all in Nigeria. At the University of Nigeria Teaching Hospital, EnuguâNigeria, ventouse is popular with rates of 3.1% in 1980, 3.5% in 2001, and 1.5% in 2006, but still on the decline. Vacuum extraction is safe and effective practice in our poor resource setting. There is a need for enhanced teaching and exposure of residents in training because widely divergent situation can exist; facilities and adequate back up for caesarean section may not always be available in our poor resource setting.