Purpose: To compare the effectiveness of the rec+tally administered misoprostol pre–operative versus post–operative in minimizing intraoperative blood loss and prevention of postpartum hemorrhage in cesarean delivery. Material and Methods: This study included 180 pregnant women at term (37 – 40 weeks) undergoing Caesarean delivery under regional anesthesia. Group I (n = 84) received 400µg rectal misoprostol preoperatively, and Group II (n = 82) received 400µg rectal misoprostol postoperatively. Hematocrit level was measured and recorded at admission as a preoperative routine investigation and repeated 24 hours following cesarean delivery . The patients were evaluated in terms of operative time,operative blood loss and any side effects of administered drugs. Results:The demographic characteristics of participants as age ,parity and gestational age were comparable between the two groups. As regard the estimated blood loss (M ± SD) during cesarean section in group I (preoperative misoprostol) was 372.33 ± 25.997 ml, in group II (postoperative misoprostol) was 722 ± 34.089 ml (p = 0.001). Hematocrit value after cesarean section was significantly lower in group II than in group I (P = < 0.001). The 2 groups were not different in terms of side–effects except for abdominal pain (P value0.02). Conclusion:Administration of rectal misoprostol prior cases are an appears to be safe, more effective than post operative administration for decreasing the amount of blood loss during cesarean section