Aim: To compare carbetocin verses oxytocin for the prevention of PPH in caesarean section. Material and Methods: A total of 200 antenatal patients at high risk for PPH were recruited and allocated into two groups.The participants were randomly allocated into two groups:Group A: Comprised of 100 antenatal patients who received a single intravenous injection of Carbetocin 100 mcg.Group B: Comprised of 100 antenatal patients who received an intramuscular injection of Oxytocin 10 units. Results: The primary outcome of uterine tone revealed that uterine atony was detected in 10% of patients in Group A and 15% in Group B, though this difference was not statistically significant (p=0.20). This suggests that Carbetocin may be slightly more effective in maintaining uterine tone, but the difference is not strong enough to conclusively favor one drug over the other.Additionally, the need for additional oxytocic drugs was reported in 8% of patients in Group A and 12% in Group B, again with no statistically significant difference (p=0.30). This further supports the conclusion that both drugs are comparably effective in preventing uterine atony and reducing the need for additional interventions.The estimated blood loss was lower in Group A, with an average of 500 ± 150 ml compared to 600 ± 180 ml in Group B. This difference approached statistical significance (p=0.05), suggesting that Carbetocin may be slightly more effective in reducing blood loss during caesarean sections. Correspondingly, the requirement for blood transfusions was lower in Group A (5%) compared to Group B (10%), although this difference did not reach statistical significance (p=0.15). Conclusion: We concluded that both Carbetocin and Oxytocin are effective in preventing PPH, with Carbetocin showing a slight, non-significant advantage in reducing blood loss and the need for additional oxytocic drugs. Both drugs were well-tolerated, with similar side effect profiles.