Background: Death due to pregnancy remains an important cause of premature mortality of women worldwide. An estimated 500,000 women die from this cause every year with up to quarter of deaths occur due to hemorrhage. Objective: The aim of this study was to compare the effectiveness and safety of carbetocin versus oxytocin in the prevention of atonic postpartum Hemorrhage (PPH) after vaginal deliveries and cesarean sections. Patient and Methods: This computerized random cross sectional prospective comparative study included a total of 400 pregnant women who were going to deliver, attending at Obstetric and Gynecological Department at El-Mataria Teaching Hospital in Corporation with Obstetric and Gynecological Department, Faculty of Medicine, Al-Azhar University. This study was conducted between October 2017 to October 2018. Results: Carbetocin was proved statistically to be more effective in preventing uterus atony and thereby PPH in comparison with oxytocin. Conclusion: It could be concluded that carbetocin is a better uterotonic agent in comparison with Oxytocin in the management of atonic postpartum hemorrhage after delivery either vaginal or cesarean section as it decreases incidence of occurrence of PPH and post-partum blood loss.