Introduction: Opinion appears divided on uterine exteriorization for uterine repair at Caesarean delivery. The available evidence appears insufficient to aid policy pronouncement of routine uterine exteriorization for repair of the lower segment incision. Whether or not it should be adopted as a routine remains an unanswered question. Aim: To evaluate the effect of extra-abdominal versus intra-abdominal repair of the uterine incision at Caesarean delivery. Methods: The study was a prospective, randomized and single blinded study conducted from April 2016 to December 2016. One hundred and seventy women were randomly assigned to groups; group ‘A’ had their repairs after exteriorization while group ‘B’ had in situ repair.. Outcomes measures include: intraoperative blood loss, postpartum anaemia, transfusion rate, mean operative time, peri-operative, wound infection rate, nausea and vomiting, The data were compared using Fisher's exact test, Chi-square and Student’s t test using SPSS version 20. Significant level of 0.05 and confidence level of 95% were used to determine the significance.