Background: Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and mortality worldwide with the highest incidence in the developing countries. Risk factors for PPH abound, however most women who experience PPH have low risk pregnancies or no risk at all. It therefore becomes imperative to prevent PPH in all pregnant women. The administration of uterotonics and in particular oxytocin, after birth is an effective component of active management of third stage of labour used in preventing PPH. Tranexamic acid (TXA), an anti-fibrinolytic agent, has recently been investigated as a potentially useful drug for prevention of PPH following vaginal delivery and merits evaluation in our environment. Objective: This study was designed to evaluate the efficacy of tranexamic acid at reducing blood loss following vaginal delivery. Methodology: This was a double-blind randomized placebo controlled study on the efficacy and safety of intravenous TXA at reducing blood loss in women undergoing vaginal delivery at the Federal Teaching Hospital Abakaliki (FETHA). Data analysis was done using Statistical Package for Social Sciences (IBM SPSS) software (version 20, Chicago II, USA). Continuous variables were presented as means and standard deviations (Mean ± 2SD), while categorical variables were presented as numbers and percentages. A difference with a p-value <0.05 was considered statistically significant.