Background: Uterine fibroids are the most common female pelvic tumors occurring in about 15% to 30% of women in the
reproductive age. When fibroids are associated with symptoms surgical intervention is often indicated.
Aim: The aim of the study is to evaluate the efficacy of administration of carbetocin in comparison to vaginal misoprostol in decreasing blood loss in women undergoing abdominal myomectomy.  Materials and Methods: The present study is a randomized controlled study carried out in Ain-Shams University Maternity Hospitals. The study included 44 women with age ranged from 25 to 40 years old, subjects were distributed randomly into two equal groups; group 1 included 22 patients who will receive 400 ug misoprostol vaginally, one hour preoperative. Group 2 included 22 patients who will receive bolus of 100 ug carbetocin slowly intravenously once starting anesthesia.  Results: Laboratory investigations in this study revealed that there was no statistical significant difference between study groups as regards age, BMI and Parity, Preoperative hemoglobin and HCT (P >0.05). As regards postoperative investigations of Hb and HCT highly statistical significant difference between study groups was found between both groups (P<0.001). In comparing study groups there were no significant differences between women of both groups regarding estimated blood loss, postoperative Hb, postoperative HCT, calculated estimated blood loss, need for blood transfusion and hospital stay (P >0.05).  Conclusion: These results showed no statistical difference was found between misoprostol and cabetocin groups in estimated blood loss, calculated estimated blood loss, need for blood transfusion and hospital stay.