Almost correct :) You need to add start to the return value:

use 5.14.2;
use warnings;

use Inline "C";

say for getRand (50, 1000, 10);

__END__
__C__

#include <stdlib.h>

void getRand (int start, int end, int iterations) {

    time_t t;
    srand ((unsigned)time (&t));

    inline_stack_vars;
    inline_stack_reset;

    int i;
    for (i = 0; i < iterations; i++) {
        int randomNum = rand () % (end - start);
        inline_stack_push (sv_2mortal (newSViv (start + randomNum))); 
+/* Add start to random number */
        }

    inline_stack_done;
    }
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