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Objective To compare the frequency and severity of celiac adhesions following cesarean sections performed with and without closure of the parietal and visceral peritoneum. Methods A retrospective cohort study involved 612 women who underwent their second lower-segment transverse cesarean section. Results Nonclosure of the parietal peritoneum at the time of the first cesarean section was associated with significantly more visceral adhesions than closure (16.2% vs. 8.1%; P = 0.003), and closure of the visceral peritoneum had a similar effect (16.1% vs. 6.7%; P = 0.02). However, the difference in rates of severe adhesions was not statistically significant (12.9% vs. 17.6%; P = 0.12). After controlling for confounding variables, it was found that closure of the parietal peritoneum reduced the rate of visceral adhesions 2.7-fold. Trial of labor before and fever after surgery increased the risk of severe adhesions 6.1-fold and 5.6-fold, respectively. Conclusion Nonclosure of the peritoneum at primary cesarean section is associated with a significantly increased risk of visceral adhesions.