Background: Although the transversus abdominis plane block (TAP) has yielded excellent pain management outcomes in ladies undergoing cesarean section (CS), it only covers the somatic component of the pain, not the visceral one, and that could be distressing for some ladies with low pain threshold. Herein, we evaluated the clinical efficacy of adding peritoneal to the TAP block in such cases. Patients and methods: This prospective randomized study included 180 pregnant ladies scheduled for elective CS, who were randomly allocated into three groups; Group A (TAP block alone), Group B (combined TAP and peritoneal block), and Group C (no block). Results: All general patient characteristics, along with operative time, showed no significant difference between the three study groups. Pain scores expressed significantly higher values in Group C compared to the other two groups, and that was evident starting from three hours after surgery till the end of the first postoperative day. Group B tended to express lower scores compared to Group A. Group C expressed a significant decline in the duration of the first analgesic request compared to the other two groups. The degree of patient satisfaction was strongly in favor of the two block groups. Group B had a better satisfaction profile compared to Group A. Conclusion: Although the TAP block alone could provide excellent pain relief after CS, the addition of a concomitant peritoneal block enhanced this effect, as it was associated with lower pain scores and better patient satisfaction.