Elective repeat cesarean contributes substantially to the overall rising rate of cesarean delivery in the United States. Many women opting for an elective repeat cesarean are good candidates for a trial of labor after cesarean (TOLAC). Physicians should be able to identify women who are good candidates for TOLAC and provide accurate patient counseling to women considering TOLAC. Currently, evidence-based recommendations regarding intrapartum management should be followed in a well-equipped facility with all necessary personnel. With the selection of proper candidates and appropriate intrapartum management, outcome can be optimized for both mother and fetus.