Caesarean Section is one of the most commonly performed surgical procedures in obstetrics and it is one of the oldest operations in surgery. Its rate across Nigeria ranges from 20.8% to 34.5%. Hemorrhage during CS is usually inevitable but should be minimized. Primary postpartum hemorrhage is an obstetric condition defined as excessive blood loss from the genital tract of 500ml or more following vaginal delivery, 1000ml or more following caesarean section or any volume loss enough to cause haemodynamic instability in a woman within 24 hours of her delivery. It is a major complication of third stage of labour3 Tranexamic acid is a synthetic derivative of the amino acid lysine that exerts its antifibrinolytic effect through the reversible blockade of the lysine binding sites on plasminogen molecules. Tranexamic acid has been shown to be very useful in reducing blood loss and incidence of blood transfusion during and after CS. OBJECTIVE To determine the efficacy of tranexamic acid in reducing blood loss in high risk patients for postpartum haemorrhage at caesarean section. METHODOLOGY The study was a randomised controlled trial involving parturients that had elective/emergency Caesarean section at the University of Ilorin Teaching Hospital. They were grouped into two arms. One of the arms had intravenous tranexamic acid 1gram while the other arm received water for injection 20 minutes before CS. Both of the arms had 10IU of oxytocin administered within one minute of delivery of the baby. Intraoperative and postoperative blood loss up to 48hours after delivery, pre and postoperative haematocrit and side effects profiles of the two 2 arms were recorded. Data analysis was done using Statistical Package for Social Sciences software (SPSS) version 21 and a p value set as 0.05 as the level of significance.