AbstractBackground: Immediate postpartum intrauterine contraceptive device (PPIUCD) insertion is approved by WHO as one of the safe and effective method of temporary contraception. Aims and Objectives: To evaluate and compare the safety and efficacy of post placental versus intra caesarean insertion of intrauterine contraceptive device (CuT 380A). Material and Methods: This prospective study was carried out on 210 patients. The patients were divided in two groups: Group I: 105 patients in whom post placental intrauterine contraceptive device was inserted within 10 minutes of delivery of placenta after vaginal delivery. Group II: 105 patients in whom intra caesarean intrauterine contraceptive device was inserted. Results: Mean age of women in group I was 24.94 ± 2.67 years & 24.81 ± 3.15 years in group II. Majority of women in group I, 40 (38.09%) women and 47 (44.76%) in group II were primigravida. In group I, 56 (53.33%) women & 51 (48.57%) in group II had PPIUCD insertion for long acting reversible contraception (LARC). In group I, 49 (46.66%) women & 54 women (51.42%) in group II had PPIUCD insertion only to space the next pregnancy. The most common complication seen at 6 weeks was missing thread in both the groups, 7.61% in group I & 28.57% in group II (p value 0.001 significant). At 6 weeks, 21 women (20%) in group not statistically significant. The incidence of missing thread of PPIUCD was more in intracesarean insertion than post placental insertion, but proper counselling and awareness motivated majority of the women for continuation of PPIUCD. The continuation rate & removal rates were same in both the groups. There was no case of pregnancy or perforation in either of the groups. Hence, PPIUCD is highly effective and safe long acting contraceptive method both in vaginal as well as cesarean deliveries with no major complications.