Background: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality globally, particularly in low-resource settings where effective, stable uterotonic agents are essential.Objective: This study compares the efficacy and safety of carbetocin and oxytocin in preventing PPH among patients at Durgapur Steel Plant Hospital, Durgapur, West Bengal.Method: A randomized controlled trial was conducted from January 2023 to December 2023 with 100 patients, divided equally into two groups: carbetocin (50) and oxytocin (50). Both drugs were administered intramuscularly post-delivery, and blood loss was measured over the first 24 hours.Results: Patients in the carbetocin group showed a significantly lower average blood loss (290 mL) compared to the oxytocin group (340 mL), with a relative reduction of 14.7% (p<0.05). Only 12% of the carbetocin group required additional uterotonics, in contrast to 24% in the oxytocin group. Side effects were slightly less frequent with carbetocin, observed in 8% of patients, versus 10% in the oxytocin group. Overall, carbetocin demonstrated enhanced stability and efficacy, with a lower incidence of PPH-related complications (10%) compared to oxytocin (18%).Conclusions: Carbetocin proved more effective than oxytocin in reducing blood loss and the need for additional uterotonics in PPH prevention, suggesting its potential as a preferable choice in clinical settings.