Background: Cesarean delivery (CD) is one of the most common surgeries performed throughout the world. Many surgical techniques exist to perform CD, but the most optimal technique to limit maternal morbidity is still subject to debate. One aspect of this debate relates to the method of uterine repair following delivery and its potential impact on maternal morbidity. Objective: To compare uterine exteriorization with in situ repair with duration of surgery and blood loss as primary outcome and postoperative or intraoperative complications of cesarean delivery as the secondary outcome. Patients and methods: The current study is a double-blinded randomized clinical trial was conducted at Beni-suef General Hospital between December 2019 and December 2020. This study was planned to be conducted on 200 pregnant females that were undergoing an elective cesarean section at full term. The patients were randomly allocated into two equal groups: Group 1: 100 women with in-situ repair of uterine incision. Group 2: 100 women with exteriorization of the uterus for repair of uterine incision. Results: Hemoglobin levels showed that the mean reduction in hemoglobin level was in the in-situ group more than the exteriorization group. As regard duration of the operation, exteriorization of the uterus had a significant less time than in-situ uterine repair. The occurrence of intra-operative nausea & vomiting increased markedly in the exteriorization group than in the in-situ group. Regarding post-operative pain, it was significantly more in the exteriorization group than in the in-situ group. There was no significant difference between in-situ and exteriorization groups regarding the post-operative febrile illness, wound complications, time of mobilization, time of return of bowel habits, time of oral intake and duration of hospital stay. Conclusion: Exteriorization of the uterus has less time consuming in the operation, decrease blood loss and decrease the post-operative drop in the hemoglobin level. On the other hand, in-situ uterine repair has much less post-operative complications (nausea, vomiting, pain and febrile illness) than the exteriorization group.