OBJECTIVES: To compare the effectiveness of sublingual Misoprostol administered immediately after delivery of the baby at caesarean section with intravenous Oxytocin infusion in producing uterine tonicity and thereby reducing blood loss at caesarean section, and to compare the accuracy in estimating blood loss at caesarean section by the Anaesthetists and the Obstetricians. METHODOLOGY: The study is a prospective randomised study involving one hundred women with singleton term pregnancy undergoing elective or emergency lower segment caesarean section under spinal anesthesia. They were randomly allocated to receive either Misoprostol (cytotec ® tablet, Searle & Co. Chicago) 400microgram (µg) sublingually or intravenous infusion of 20 units of Oxytocin (Rotexmedica, Trittau, Germany) soon after delivery of the baby. The main outcome measures were blood loss at caesarean section estimated by both the Anaesthetist and the Obstetricians, the pre and post operative packed cell volume, need for additional oxytocics and drug side effects.