To assess the effect of prophylactic tranexamic acid (1 g) in reducing postpartum blood loss and the incidence of PPH after vaginal delivery, in addition to active management of third stage of labour. In this randomized controlled trial, 650 women with singleton pregnancies of ≥ 34 weeks gestation who were undergoing vaginal delivery were included. Eligible women were randomly assigned to receive either 1 g of tranexamic acid or placebo intravenously in addition to active management of third stage of labour. Calibrated blood collection bags were used to measure postpartum blood loss during the third and fourth stage of labour. Out of 886 women who were approached for the study, 650 who met the inclusion criteria were enrolled, and 320 in group A and 321 in group B were analysed. Maternal characteristics were similar in both groups. Mean blood loss did not differ significantly among the intervention and placebo groups (378.5±261.2 ml vs. 383±258.9 ml; p = 0.93). The incidence of primary postpartum hemorrhage was comparable in both groups (Group A: 15.9%, Group B: 15.3%, p = 0.814). The median (interquartile) quantitative fall in haemoglobin within 12-24 hours following delivery in group A was 0.60 g% (0.40-0.90) and group B was 0.60 g% (0.40-0.80) which were comparable in both groups (p=0.95). The most common adverse effect reported was dizziness and there were no thromboembolic events at three months follow-up in both groups. The use of tranexamic acid as a prophylactic measure along with active management of third stage of labour does not provide additional benefit in reducing the postpartum blood loss as well as incidence of PPH after vaginal delivery.