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Background: Type 1 diabetes mellitus (T1DM) incidence is increasing as well as the rates of cesarean sections. Current research has not been conclusive as to whether this relationship is causal. Objective: This evidence-based systematic review aimed to investigate the risk of neonatal development of T1DM in vaginal versus cesarean delivery. Methods: Three peer-reviewed journal articles of the highest level of evidence and quality were found searching multiple databases to answer the research question. An induplicate search and review process (title, abstract, and full text) was conducted to select the included studies. A quality assessment and data extraction were utilized to qualitatively analyze each included study. Results: Cesarean section was determined to increase risk of T1DM in comparison to unassisted vaginal delivery in one of the three studies. Instrumental vaginal delivery, in one of the studies, showed a moderately increased risk of offspring development of T1DM before the age of 15 except in sibling control analysis which showed no increased risk of T1DM with either method of vaginal delivery. Children born by prelabor cesarean section had a higher risk of developing T1DM in childhood than children born by vaginal delivery in two of the studies. One study found intrapartum cesarean section, as opposed to prelabor cesarean section, to be associated with increased risk of T1DM development. Conclusion: Results were inconclusive in regard to a definitive causal association of increased risk of T1DM and one particular method of delivery, specifically prelabor or intrapartum cesarean section. Unassisted vaginal delivery was the only delivery method found to not increase risk of T1DM in all three studies. Adjusting for all possible confounding factors in future studies v would be necessary to truly identify a causative relationship between method of delivery and T1DM risk.