AIM: our paper aims to examine the effectiveness and safety of rectal misoprostol and intravenous carbetocin in preventing blood loss during open myomectomy. Methods: Abdominal myomectomy was performed on 63 female patients who matched the inclusion criteria and had uterine fibroids. With a ratio of 1:1:1 (n=21 in each group), patients were randomly allocated to one of three groups: A for the carbetocin group, B for the misoprostol group, or C for the control group. The three groups were examined with regard to the estimated blood loss (EBL) during open myomectomy, the need for blood transfusion, the length of the procedure, the postoperative hematocrit and hemoglobin, the negative effects of carbetocin and misoprostol, the decline in hemoglobin, and the decline in hematocrit.