Background: postpartum hemorrhage (PPH) is an obstetrical emergency that can occur after vaginal or cesarean delivery. It is the most common cause of maternal morbidity and may be complicated by shock, renal failure, acute respiratory distress syndrome, coagulopathy, and Sheehan syndrome. PPH is one of the top five causes of maternal death in both developed and developing countries. The Aim of work to assess the incidence and outcome of primary PPH in Zagazig University Hospitals to assess magnitude of the problem. Methods: This is a prospective cohort clinical study which was conducted in Zagazig University Maternity Hospital. Cases diagnosed with primary post partum haemorrage who delivered at or admitted to maternity hospital at Zagazig University Hospitals. Results: 3000 cases were admitted either delivered at our hospital or outside and admitted for immediate post partum hemorrhage, 74 cases were diagnosed by immediate post partum hemorrhage (2.5%). percentage of PPH in our study was found to be 2.5%, the most common causes of PPH are uterine atony 71.6% , obstetric trauma 18.9%, the most common risk factors for PPH are placenta previa 28.4%, PIH 21.6%, Anemia 18.9%, 10.8% experienced previous postpartum hemorrhage, the majority of the studied women had no medical problems (75%), there was significant relation between PPH occurrence and past medical history, anemia and previous PPH, the tertiary care was the commonest place for delivery followed by private (94.6% and 4.1% respectively), 49 patients received 1_5 units blood (66.2%), 50 patients have moderate degree of shock (67.5%).Conclusion: primary PPH was found to be 2.5%, most common causes of PPH are uterine atony 71.6% , obstetric trauma 18.9%.