Background: Rising caesarean section rates and concerns regarding maternal safety continue to shape modern obstetric practice, especially in low-resource settings. Therefore, this study assessed postpartum hemorrhage and perineal injury among women undergoing VBAC at Dhaka Medical College Hospital. Methods: This cross sectional study was conducted in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, from 16 April to 15 October 2023, enrolling 100 pregnant women with one or two prior caesarean sections planned for vaginal delivery. After ethical approval and informed consent, data were collected with a structured questionnaire, and women undergoing trial of labour after caesarean (TOLAC) were monitored using maternal and fetal parameters, partogram, and oxytocin as per protocol. Outcomes included induction to delivery interval, mode of delivery, and maternal complications, and data were analyzed in SPSS. Results: Among 100 VBAC cases, mean age was 29.8 ± 11.4 years, with most aged 20–30 years (58.0%) and 82.0% at ≥37 weeks gestation. Hemoglobin ≥11 g/dL was seen in 72.0%, and membrane status was nearly equal (intact 52.0%, ruptured 48.0%). Mean induction–delivery interval was 8.37 ± 5.3 hours, with 64.0% delivering within 7–12 hours. VBAC success was 76.0% and repeat caesarean 24.0%. Overall, 83.0% had no complications; PPH occurred in 9.0%, perineal injury in 3.0%, and no uterine rupture was noted. Conclusion: VBAC is a safe and effective mode of delivery in appropriately selected women, with low rates of postpartum hemorrhage and perineal injury.