Postpartum hemorrhage (PPH) is defined as blood loss of greater than 500 mL after giving birth vaginally or as blood loss greater than 1000 mL after cesarean section. The immediate postpartum period is the most critical time during which almost 90 % of deaths occur within the first 4 hours of delivery. PPH have many potential causes, but the most common cause is uterine atony. Uterine atony accounts for 75-90 % of postpartum hemorrhage.Misoprostol is a prostaglandin E1 analogue registered for the prevention and treatment of gastric ulcers, is well known for its off-label use as an uterotonic agent. It is inexpensive, does not require refrigeration, dark storage or administration by an attendant as it is stable at room temperature, easy to administer. It has a shelf life of several years. It doesn't cause hypertension and therefore it can be administered to hypertensive patients and also those with cardiac disease. The use of misoprostol has therefore a practical role in uncomplicated low risk spontaneous vaginal delivery, especially in developing countries when resort to parenteral drug administration is difficult. This study aimed to assess the efficacy of sublingual misoprostol at cord clamping for the prevention of postpartum hemorrhage.This study has shown that sublingual misoprostol 200 μg at time of cord clamping appears to be more effective than no treatment in minimizing the blood loss in low risk pregnant women in the third stage of labor but it is no more effective than no treatment in preventing postpartum hemorrhage as additional uterotonic agents were given if the uterus was not well contracted or if the bleeding was considered to be more than usual.