Background: Primary postpartum hemorrahge is a leading cause of maternal mortality and morbidity. Prevention of excessive blood loss at caesarean section is of utmost concern to the obstetrician. Blood sparing modalities are useful in reduction of the amount of blood loss at caesarean section. Tranexamic acid is an antifibrinolytics agents which have been widely used in the reduction of blood loss at surgeries. Oral clonidine is an alpha-2 adrenergic agonist used in various surgeries including Caesarean section due to its controlled hypotensive effect and it’s peripheral vasoconstrictive effect to reduce blood loss. Objective: This study compared the effectiveness of Premedication with oral clonidine versus intraveinous tranexamic acid in reduction of blood loss during elective caesarean section in AEFUTH Abakaliki. Methodology: This was an equivalence double blind, double dummy randomized controlled clinical trial among parturient undergoing elective caesarean section in Alex Ekwueme Federal University Teaching Hospital Abakaliki(between 15th September 2021 and 14th March 2022).112 Eligible women with term pregnancies who had elective Caesarean section were randomized to receive oral medications of either 0.2mg oral clonidine or 100mg Tab Vitamin C, 60 mins prior to surgery or intravenous medications of 1 gram of intravenous tranexamic acid or 10mls of sterile water each administered 10 minutes after skin incission.The oral clonidine and the tranexamic acid were the active drugs while the tablet Vitamin C and water for injection were the placebo.The parturients were randomized into two arms (56 parturients in each arm).Group A received 100mg of tablet Vitamin C (placebo) and 1gram of intraveinous tranexamic acid. Group B received 0.2mg of oral clonidine and 10mls of sterile water (placebo). Primary Outcome Measures were estimated blood loss following Caesarean SectionandPrimary Postpartum Haemorrhage after xvii Caesarean Section(blood loss ≥1000ml) while the Secondary Outcome Measures includes;Change in haematocrit 48 hours after delivery, the need for additional uterotonics/measures to control bleeding,the need for blood transfusion following caesarean delivery, Materno-fetalside effects (nausea, vomiting, diarrhea, fever, shivering) and low APGAR Scores in the 1st and fifth minute.