Background: In modern obstetric practice, it is usually considered beneficial to administer adjunctive and prophylactic uterotonic agents to pregnant women in labour with identifiable risk factors for uterine atony after conventional active management of the third stage of labour. Objective: To compare the outcome of use of adjunctive oxytocin infusion versus rectal misoprostol in preventing postpartum haemorrhage after conventional active management of third stage of labour. Methodology: One hundred and twenty (120) parturients with identifiable risk factors for uterine atony were randomized. One group (60 participants) received oxytocin infusion of 40IU in 1litre of normal saline and the second group (also 60 participants) received 600μg of rectal misoprostol after conventional active management of the third state of labour. Outcome measures include postpartum blood loss, incidence of postpartum haemorrhage (PPH) and requirement for additional uterotonics, postpartum haematocrit change, need for blood transfusion and incidence of complicatios (side effects)