Background: Cesarean section(CS) is a common surgical procedure worldwide, essential for saving lives and preventing birth complications. This study aims to compare the prophylactic use of oxytocin and carbetocin in cesarean deliveries to prevent primary PPH. Materials & Methods: A prospective, comparative study recruiting 130 pregnant women undergoing cesarean section with 65 in each group who all came under inclusion criteria. Women undergoing cesarean delivery were randomly assigned to receive either oxytocin 10 IU IM or carbetocin 100 ug IV prophylactically. Data on blood loss, the need for additional uterotonics, adverse effects, and overall maternal outcomes were collected and analyzed. Results: Patients in the carbetocin and oxytocin groups had mean ages of 29.57±3.64 and 29.98±3.70 years, respectively. The groups' ages were comparable because there was no significant age difference between them. Between the groups, there was no significant (p=0.98) difference in socioeconomic status and no significant difference was seen in otherdemographic characters. In the Hemodynamic effects, both drugs have ahypotensive effect but we found greater reduction in systolic and diastolic blood pressure in oxytocin group. The amount of blood loss both intraoperative (p=0.51) and postoperative (p=0.24) was comparable and there was no significant (p>0.05) difference in blood loss between the groups. The oxytocin group (41.5%) required more uterotonics than the carbetocin group (18.5%), indicating that carbetocin may be a more effective single agent prophylactic. Conclusion: Carbetocin is more effective than oxytocin in preventing primary PPH in cesarean deliveries. Its use could lead to better maternal outcomes and reduced healthcare costs related to PPH management.