Introduction: The intention of a woman to breastfeed is one of the predictors of breastfeeding initiation and duration. Objective: The aim of this study is to determine exclusive breastfeeding (EBF) intention among women admitted for elective cesarean delivery in Kelantan and their postnatal EBF practices. Methods: A total of 171 women, mostly Malays, admitted for elective cesarean delivery at two tertiary hospitals in Kelantan participated in this prospective cohort study. The Malay version of Infant Feeding Intentions (IFI) scale was administered one day before the surgery to determine the EBF intention, and follow-up phone calls were made at one month, three months, and six months after delivery to determine the actual EBF practices. Results: Before delivery, 86.5%, 82.5% and 77.2% of the women somewhat agreed or very much agreed to practice EBF for 1, 3 and 6 months respectively and the actual EBF practices after delivery were 80.1%, 59.6%, and 42.1%. Women who had the intention to practice EBF for 6 months were about 2 times more likely to practice EBF for 6 months than those who did not have the intention to EBF (OR 2.19, 95% CI: 1.01-4.76). No significant association was found between EBF intention and the actual EBF practices at 1 month and 3 months postnatal. Conclusions: The number of women who practiced EBF after cesarean delivery was lower than those who had the intention prior to delivery. The number further declined as the child grew older. Prenatal EBF intention was associated with actual postnatal EBF practices at 6 months.