AbstracBackground; Postpartum Haemorrhage (PPH) is one of the important cause of maternal mortality in both developed and developing countries. Blood loss of 1000ml or more occur in 1-5% of deliveries². Internal iliac artery and its branches supply the pelvic organs. Bilateral ligation of Internal Iliac Artery (IIAL) is one of the life saving surgical technique in case of post partum haemorrhage Objective: To study the role of Bilateral ligation of Internal Iliac Artery (IIAL) in arresting and preventing PPH. Design: Retrospective chart review of women undergoing therapeutic IIAL for PPH or prophylactic IIAL for risk of PPH from April 2010 to July 2016. Setting: A-Tertiary Hospitals in Pune- Lokmanya Multispeciality Hospital Chinchwad and Nigdi Pune and Pawana multispeciality Hospital Somatane Pune B- Ashwinii Nursing Home and Laproscopy Centre Thergaon Chinchwad Pune. Sample: Women admitted in these above hospital who underwent IIAL to control or prevent PPH. Methods: Bilateral IIAL was performed in all cases. Result and Conclusions: Out of 50 women who underwent IIAL, 41 had therapeutic IIAL from PPH and 9 had Prophylactic IIAL. Obstetric hysterectomy done in 4 cases after IIAL failed to arrest haemorrhage. Failure to control haemorrhage was evident immediately and bleeding arrested by IIAL did not recur and no subsequent procedure required in any case. Out of 9 women at risk of PPH undergoing prophylactic IIAL none had subsequent haemorrhage. One women had iliac vein injury which was repaired by vascular surgeon without any morbidiry. There were no ischemic complications during in patient stay and up to 6 weeks and no deaths in these cases. IIAL is useful procedure in treatment and prevention of PPH from any cause. Early resort to IIAL effectively prevents hysterectomy in women with atonic PPH. In traumatic PPH, IIAL facilitates hysterectomy or repair as indicated and prevent reactionary haemorrhage.