BACKGROUND: Postpartum hemorrhage remains a significant cause of maternal morbidity and mortality worldwide. Uterine atony is the commonest cause of postpartum hemorrhage and is a common complication of caesarean section. AIM: To compare the effect of initiating intravenous oxytocin infusion before uterine incision versus after umbilical cord clamping on blood loss during elective caesarean section. METHODOLGY: It was a double blinded randomized clinical trial which involved 116 participants(58 on either arm). Participants were consenting women who had elective caesarean section. The first group(Group A) received 40 IU oxytocin mixed in 1 litre of Normal saline and started just before uterine incision while the other arm(Group B) received the same dose of oxytocin infusion after umbilical cord clamping. The estimation of blood loss was done from delivery of placenta till 2 hours post-operation. STATISTICAL ANALYSIS: Collected data was analyzed using Statistical Package for Social Sciences (SPSS) software (version 24, Chicago Il, USA)). Continuous variables were presented as mean and standard deviation (Mean ± SD), while categorical variables were presented as numbers and percentages. Chi-square test(X2 ) was used for comparison between groups for categorical variables while t-test was used for comparison of means between groups for quantitative variables. A p-value < 0.05 was considered statistically significant.