Objective To evaluate the type, frequency, and criteria for episiotomy performed by obstetricians in Brazil and assess differences in practice by generation or workplace. Design Cross-sectional study. Setting Data collection via an online platform. Population or Sample The study included 488 obstetrician-gynecologists practicing obstetrics in Brazil. Methods Data were collected using an online form and organized into tables for analysis. Descriptive and inferential statistics were performed to identify trends and associations. Main Outcome Measures Frequency and type of episiotomy, criteria for performance, and differences by age, generation, or workplace. Results Among 488 participants, most were female, aged 31–50 years, graduates from public universities, and employed in both public and private healthcare systems. In the sample, 36.3% reported performing episiotomies occasionally, with the mediolateral type being the most common. Older doctors were more likely to perform episiotomies than younger doctors. The main indications included instrumental birth, imminent perineal laceration, fetal distress, macrosomia, and abnormal presentation. Professionals working solely in private healthcare reported higher frequencies of episiotomy use compared to those in public or mixed systems. Doctors trained before 2000 were significantly more likely to perform episiotomies, with an odds ratio of 12.43 (CI 5.90–26.19, p<0.001), indicating a 1243% higher likelihood of performing the procedure. Conclusions Episiotomy rates are decreasing in Brazil, with younger obstetricians performing the procedure less frequently. Future training should prioritize teaching proper techniques and indications to ensure effective and safe outcomes, reducing the risk of severe perineal trauma and adverse neonatal outcomes.