To compare the efficacy and safety of prophylactic carbetocin versus oxytocin in the prevention of postpartum hemorrhage (PPH) after normal vaginal delivery. Methods: This was a single-blind randomized controlled trial including 84 women undergoing vaginal delivery. Group A received 100 mcg IV carbetocin; Group B received 10 IU IM plus 10 IU IV oxytocin in 500 ml RL. Primary outcomes included postpartum blood loss and changes in hemoglobin/hematocrit levels. Secondary outcomes included the need for additional uterotonics, blood transfusions, and adverse effects. Results: Mean blood loss was significantly lower in the carbetocin group (197.36 ± 77.63 ml) compared to oxytocin (316.64 ± 107.71 ml, p=0.04). Postpartum hemoglobin and hematocrit decline were less significant in the carbetocin group (p<0.001). No significant differences were observed in the need for transfusion (p=0.69) or adverse effects (p=0.75). Conclusion: Carbetocin significantly reduces postpartum blood loss compared to oxytocin, with a comparable safety profile. Its use may be beneficial in resource-limited settings due to its heat stability and single-dose regimen. Keywords: postpartum hemorrhage, carbetocin, oxytocin, vaginal delivery, randomized controlled trial