Background: Cesarean Section (CS) has been associated with major intra operative Blood loss. Obstetric hemorrhage has been identified as a major cause of direct maternal mortality, maternal near miss and Maternal morbidity. Blood transfusion is often associated with CS. With the advent of various medical and surgical techniques to prevent excessive blood loss during CS, the need for blood trans fusion in every CS procedure need to be reviewed. High risk pregnancy cases may require blood transfusion. However, 90% of low risk pregnancy cases may not require blood transfusion, especially when the application of blood loss preventive measures are put in place. Aim: The aim of this study is to ensure thorough review of patients peri-operatively, and to find out if intra-operative measures can reduce the need for blood transfusion during CS. Method: This was a retrospective cross sectional study of 1000 patients who had Cesarean section between January 2020 to December 2021. Five hundred (500) of them were cases associated with high risk factors for massive hemorrhage at CS, and thus with increased need for blood transfusion. The other 500 were low risk cases for intra operative hemorrhage during CS. It was expected that blood transfusion will be minimal within this group. The result was that these blood loss preventive measures helped to reduce intra-operative blood loss, thus reduced the need for blood transfusion. In addition, the modal units of blood transfused was 2units, unlike previous studies where modal Transfusion was 3 units [1,3,4] . Two hundred and three (203) 40.6% were transfused in the high risk group. Only 11(2.2%) were transfused in the low risk group. Conclusion:The need for blood transfusion during cesarean section was reduced with adequate perioperative preparations. Optimizing maternal hemoglobin concentration during the antenatal period may reduce the incidence of cesarean section related blood transfusion.