Background: Leiomyomas cause significant morbidity due to abnormal uterine bleeding and pelvic pressure symptoms. Carbetocin is a long-acting synthetic agonist analogue of the human oxytocin which induces uterine contractions. The study aims to compare intravenous carbetocin clinical effect and its myometrial injection to decrease blood loss in myomectomy operation. Methods: This randomized controlled study involved 60 patients who clinically and sonographically diagnosed with single intramural fibroids. Patients were allocated into three equal groups: Group A (Intravenous cabetocin group), group B (Myometrial carbetocin group) and group C (Control group). All patients underwent abdominal ultra-sonography, routine laboratory investigation. Results: The blood loss was more in-group B than the group A with high significant difference between the three groups (P<0.001). Preoperatively there was significant difference in Hb between the three groups (0.002), but postoperatively there was insignificant difference in Hb between the three groups both groups. Conclusions: The use of intravenous carbetocin injection during preoperative abdominal myomectomy operation is more effective in decreasing the blood loss, shorter operative time, decreasing blood transfusion and rapid postoperative recovery than the use intramyometrial Carbetocin injection.