Background: Majority of women are in need of effective contraceptive method for spacing. The unmet need for contraception results in unintended pregnancies, with increased maternal and neonatal complications. PPIUCD insertion is an effective contraceptive method, reduces unintended pregnancy and decreases health care cost expenditure. Objective: This study aims to evaluate long term complications like bleeding, pain, expulsion rate, perforation, infection, missing strings and continuation rate. Method: This prospective observational study was carried out in a tertiary care hospital in Chennai, between Jan 2012 - June 2012. CuT 380A was inserted immediately following placental delivery in caesarean section or in normal delivery or within 48 hours of normal delivery. They were followed up at the time of discharge, at 6 weeks, then at 6 monthly intervals till 30 weeks. Results: A total of 300 PPIUCD acceptors were followed up for 30 months. Most of our acceptors are primipara group (n=199, 66.4%). Most of the insertions are in caesarean deliveries. (n=235, 78.3%), followed by post placental insertions (n=42, 13%) and immediate post partum (n=23, 7.7%). Continuation rate is high 90.7 %( n=272) at the end of 1 year and 84.3% at the end of 30 months. Expulsion rate was 4.7%, bleeding in 8.7%, pain in 8.4% and infection in 1% of acceptors. Removal rate at 30 months was 11%, majority of the removal was for opting to go for permanent method of sterilization (n=19, 6.33%), followed by planning for 2nd child (n=7, 2.3%). Pain was the cause for removal in only 0.67%, bleeding in 1.67%. Conclusion: PPIUCD is safe and effective method of contraception with high continuation rate, low expulsion and complication rates.