“‘latex Objective: This study investigates the efficacy of the novel Transvaginal Uterine Artery Clamp (TVUAC) as a second-line intervention for controlling post partum hemorrhage (PPH). Design: Descriptive, cross-sectional, observational study. Setting: Department of Obstetrics and Gynecology in a tertiary care center in Eastern India. Sample: 254 women with PPH (>500ml) following vaginal deliveries unresponsive to first-line uterotonics. Methods: Post Vaginal delivery, when uterotonics failed to control PPH, TVUAC were applied bilaterally thereby occluding the uterine arteries providing immediate hemostasis. Data collection and relevant statistical analysis was performed. Main Outcome Measures: TVUAC success rate, requirement of third-line surgical interventions, and factors associated with failure. Results: TVUAC successfully controlled PPH in 97% cases (247/254; 95% CI: 94.6%-98.6%), with only 3% (7/254; 95% CI: 1.4%-5.4%) requiring laparotomy. Clamp failure was significantly higher in referred cases (16.7%, p=0.034), instrumental deliveries (33.3%, p=0.02), and those with hypertensive disorders (6%). No maternal deaths or recurrent PPH occurred among successful cases. All patients received blood transfusions, with a moderate positive correlation between uncontrolled PPH and the need for ≥5 units of blood products. Conclusions: TVUAC, an effective, minimally invasive, and accessible second-line intervention, offers a scalable solution for settings with limited surgical capacity. Its potential to transform PPH management can save countless lives by either immediate control or limiting blood loss during transport to higher facility. Funding: None. Keywords: Postpartum hemorrhage, transvaginal uterine artery clamp, second-line intervention, maternal mortality, resource-limited settings.