Background: Postpartum hemorrhage defined as the condition blood loss more than 500 mL from the female genital tract after vaginal delivery of the fetus (or >1000 mL after cesarean section). Case Presentation: Mrs. FA 31 year’s old G2P1A0 40 weeks age gestation preeclampsia with main complaints dyspnea and swollen legs. Physical examination showed decreased saturation, increase blood pressure, rhonci, and pitting edema of the pedal. Cardiomegaly with pulmonary edema on x-ray, elevated liver enzymes, LEA value +3, perfectly compensated respiratory alkalosis and electrolyte imbalance on laboratory test. Four-hour post C-section she got postpartum hemorrhagic and given oxytocin due to maximizing use of uterotonic agent, MgSO4 stopped and patient reported with postpartum eclampsia. Conclusion: Many studies discus other drugs to replace oxytocin, considering side effects to prevent postpartum hemorrhage. Carbetocin could be one potent agent of uterotonic agents with lower side effect.