Background: Post-dural puncture headache (PDPH) is a common and distressing complication following spinal anaesthesia, particularly in caesarean section patients. The management of PDPH often includes prolonged bed rest; however, the impact of early ambulation on the incidence and severity of PDPH remains underexplored. Methods: This prospective, randomized study included 140 women undergoing elective caesarean section under spinal anaesthesia. Participants were divided into two groups: Group R (n=70) remained in the supine position for 12 hours postoperatively, while Group A (n=70) began ambulation after 6 hours. The primary outcome was the incidence of PDPH, with secondary outcomes including severity of PDPH, time to onset, duration of hospital stays, and postoperative complications. Results: The incidence of PDPH was significantly lower in Group A (10%) compared to Group R (50%) (P<0.001). Group A also experienced less severe PDPH, with a mean VAS score of 3.5 versus 4.7 in Group R (P=0.002). The onset of PDPH was delayed in Group A, with only 26.7% of cases occurring within the first 24 hours compared to 60% in Group R (P=0.015). Furthermore, Group A had a shorter hospital stay (P=0.031) and fewer complications, including nausea and vomiting (P=0.042 and P=0.038, respectively). Conclusion:Early ambulation significantly reduces the incidence, severity, and onset of PDPH, and is associated with shorter hospital stays and fewer complications in cesarean section patients. These findings suggest that early mobilization should be considered in postoperative care protocols.