Internal iliac artery ligation is a highly effective method of stemming uterine haemorrhage which is grossly underused in obstetrics and gynaecology. Two cases of incessant haemorrhage at LSCS one presented which did not respond to uterine artery ligation. One case was associated with placenta accreta, the other with a lower segment tear. In both cases unilateral internal iliac artery ligation effected cessation of haemorrhage and permitted uterine conservation. The procedure was utilised in a further two cases to stem haemorrhage associated with uterine perforation and broad ligament haematoma after termination of pregnancy and pelvic haematoma secondary to a slipped uterine artery ligature following hysterectomy.