Objective: Uterine after-pains are among the most prevalent complaints after natural vaginal delivery. Non-pharmacological treatment modalities to relieve after-pains are an important care priority. This study aimed to investigate the effect of foot reflexology in the fourth stage of labor on after-pains in multiparous women.Methods: This single-blind randomized clinical trial recruited 80 eligible pregnant women presenting to Allameh Bohlool Hospital in Gonabad and 17-Shahrivar Hospital in Mashhad in 2019. In the first and second hours postpartum, the reflexology group received 10 minutes of general massage and specific reflexology massage on each foot in uterine, pituitary, and solar plexus points. The control group received 10 minutes of general massage, and then rotational massage on a neutral point on the lateral side of the heel. The pain was measured every hour up to 4 hours postpartum using a visual analog scale. The collected data were analyzed in SPSS-16 software at a significance level of P<0.05.Results: The median of after-pain score in the first hour postpartum was not statistically significantly different between the two groups (P=0.05), but it was lower in the reflexology group at the second (P=0.04), third (P<0.001), and fourth hours postpartum (P<0.001). The mean total after-pain score of the four hours postpartum was significantly lower in the reflexology group (P<0.001).Conclusions: The results revealed that foot reflexology in the fourth stage of labor has positive effects on the relief of uterine after-pain. It is therefore recommended that reflexology be used to reduce postpartum uterine after-pain.