Background: Hemostasis is an integral and very important aspect of surgical practice. In the developing world, about 1.2% of deliveries are associated with PPH and when PPH occurred about 3% of women died. Causes of postpartum hemorrhage are uterine atony, trauma, retained placenta or placental abnormalities, and coagulopathy, commonly referred to as the "four Ts". Objective: To study the effect of gelfoam in hemostasis as adjuvant in control of primary postpartum hemorrhage. Patients and Methods: This was a Cohort study conducted at Sayed Galal University Hospital, Al-Azhar University Faculty of Medicine during the period from May 2019 to May 2020. A number of 60 cases of postpartum hemorrhage and role of gel foam in hemostasis as adjuvant in control of primary postpartum hemorrhage. Results: The findings of the present study indicate that local hemostatic agent “gel foam" was useful as adjuvant in control of primary postpartum hemorrhage in cesarean section. Local hemostats reduce the use of systemic hemostats, shorten the time required to achieve hemostasis. The delay in the recovery of bowel motility was due to the local hypersensitivity reaction caused by gelatin sponge and/or dislocation of this local hemostat. Conclusion: Local hemostatic agent “gel foam" was useful in adjuvant in control of primary postpartum hemorrhage in cesarean section.