BACKGROUND: The current trend towards early discharge from hospital has led to the growing interest in patient management that allows more rapid recovery and resumption of normal activities. Literatures have shown that early oral feeding improves energy and protein intake to maintain a positive caloric and nitrogen balance; reduces protein store depletion, improves wound healing and aids faster recovery. From a clinical observation of early complaint of hunger and of having passed flatus by patients who had rectal misoprostol for primary postpartum haemorrhage prevention after Caesarean section, it will be worth-while studying if the drug induces early return of intestinal motility as this may confer added advantage on patient’s care. OBJECTIVE: The study aims to determine the added effect of rectally administered misoprostol post-caesarean section in inducing intestinal motility when compared to those who had oxytocin infusion for primary postpartum haemorrhage prevention. METHOD: Two Hundred and Eighteen patients for Caesarean section with risk factors for primary postpartum haemorrhage were randomised into either Misoprostol or Oxytocin infusion group after informed consent. All patients had intravenous bolus of 5 IU Oxytocin before the delivery of the placenta. But in addition, patients assigned to Oxytocin group received 20 IU of Oxytocin in 500ml of 5% Dextrose saline as infusion over 4 hours post surgery at flow rate of 20drops/min while Misoprostol group received 600μg rectal misoprostol and a plain infusion that ran at the same flow rate over 4 hours after surgery. The infusions in both groups were similarly labelled with instruction on the flow rate only while separate intravenous access was used for the normal post-operative fluid therapy in both groups. Both patients and outcome assessor (the researcher) were blinded to study medications. Primary outcome measured was time of passage of flatus post-operation. GIT side effects, need for additional analgesic, immediate 4 hours post-operative blood loss, and length of hospital stay were also assessed.