Background: Misoprostol is a prostaglandin E1 analogue with good uterotonic properties and has been evaluated for both prevention and treatment of postpartum haemorrhage. While the various studies recognised the efficacy of misoprostol in decreasing intraoperative blood loss, there was no consensus on the most effective route of administration. Aim: To estimate intraoperative blood loss during elective Caesarean delivery with the sublingual and rectal route of administration. Objectives: To compare the perioperative haemoglobin differences with the sublingual and rectal route of administration. To compare the side effects of misoprostol with respect to sublingual and rectal route. Methodology: An experimental study on 72 pregnant women for elective Caesarean section who were randomised either to receive 600 g misoprostol rectally or sublingually. Blood loss estimation was done using direct measurement and weighing. Shivering, pyrexia and vomiting as the side effects of the trial drug were also analysed.