Obstetric hemorrhage is the most common and dangerous complication of childbirth. This was redefined in 2017 by the American College of Obstetrics and Gynecology as a cumulative blood loss greater than 1000 mL with signs and symptoms of hypovolemia within 24 hours of the birth process, regardless of the route of delivery. Postpartum hemorrhage is the leading cause of morbidity and mortality in childbirth. PPH occurs in approximately 1% to 6% of all deliveries. Uterine atony, the primary cause of PPH, accounts for 70% to 80% of all hemorrhage. Conservative surgical management in PPH includes surgical procedures that can avoid hysterectomy and its morbidity, as well as can preserve patient’s fertility. The most used procedures are the hemostatic sutures, which refer to the ligation of pelvic vessels (LPV) and uterine compressive sutures (UCS). The success rate will depend on the cause, intensity and location of the bleeding as well as on the type of procedure chosen and the surgeon’s ability to perform the procedure. Theoretically, UCS should be able to control bleeding more quickly and in a safer manner when compared to hysterectomy. However, when it fails to stop PPH, radical surgery is indicated, since the patient's prognosis may worsen (as the time elapsed from diagnosis until the control of the bleeding will be prolonged) and the mortality rates may increase. For these reasons the conservative surgical management should be included into a PPH protocol (like intravenous tranexamic acid and uterine massage), so the provider is able to decide, properly, how and when to use them.