Cesarean delivery is the commonest woman surgery worldwide. Postpartum hemorrhage is blood loss >1000 ml after SC. This study conducted to assess the efficacy of sublingual versus rectal misoprostol on intraoperative and postoperative blood loss and the subsequent effect on hemoglobin values. This was a prospective study that included 100 pregnant women divided randomly into two equal groups, 50 participants each admitted to the department of obstetrics and gynecology, Beni-Suef university hospital- Egypt from August 2018 to May 2019. Participants received 400 mcg rectally or sublingually before SC after induction of spinal anesthesia. The primary outcome measure perioperative hemoglobin and hematocrit values regarding blood loss. Comparisons between groups were carried out by Student's t-test (parametric data), Mann Whitney test (Non-parametric data), and Chi-Square test. P<0.05 was considered statistically significant