Post partum hemorrhage is the single most important cause of maternal mortality worldwide accounting for 13% of maternal deaths in developed countries and 34% in developing countries. Blood loss > 1000 ml amounts to major post partum hemorrhage occurring in 1-5% of deliveries. The chapter describes in detail resuscitative measures followed by various conservative medical and surgical techniques which may prevent a hysterectomy. Ample illustration with explicit figures demonstrating conservative surgical techniques are provided. Uterine tamponade balloons, uterine artery embolization, newer developments including use of recombinant factor VII and oxytocin agonist carbetocin are also discussed in detail.