Introduction: Effective pain management following caesarean section is crucial for maternal well-being and early recovery. This study aimed to evaluate the efficacy of ultrasound-guided Transversus Abdominis Plane (TAP) block in reducing postoperative pain and opioid consumption after caesarean delivery. Methods: In this prospective, randomized, double-blind, placebo-controlled study, 140 women undergoing elective caesarean section were randomly assigned to receive either ultrasound-guided TAP block with local anesthetic (n=70) or a sham procedure with saline (n=70). Pain scores, opioid consumption, time to first opioid request, maternal satisfaction, time to mobilization, time to first breastfeeding, and side effects were assessed over 48 hours postoperatively. Results: The TAP block group demonstrated significantly lower pain scores at all time points (p<0.001), reduced total opioid consumption (15.3 ± 7.2 mg vs. 32.7 ± 12.5 mg morphine equivalents, p<0.001), and delayed time to first opioid request (8.5 vs. 2.3 hours, p<0.001) compared to the control group. Maternal satisfaction was higher, and times to mobilization and first breastfeeding were shorter in the TAP block group (p<0.001). The incidence of opioid-related side effects was significantly lower in the TAP block group. Subgroup analysis revealed slightly reduced efficacy in patients with BMI ≥ 30 kg/m². Conclusion: Ultrasound-guided TAP block is an effective technique for post-caesarean pain management, resulting in improved analgesia, reduced opioid consumption, higher maternal satisfaction, and earlier achievement of recovery milestones. These findings support the integration of TAP block into multimodal analgesia protocols for caesarean delivery, particularly within enhanced recovery pathways.