Background:The ideal agent to induce labor must effectively convert an unfavourable cervix to one receptive to delivery but also needs to be safe, easy to administer and acceptable to the patient. Prostaglandins have a central role in the physiological events of cervical ripening and parturition and have been widely used for induction of labor.Aim: To compare the efficacy of dinoprostone gel with dinoprostone insert for induction of labor in nulliparous women with unfavorable cervix in terms of Mode of delivery (vaginal versus caesarean), Induction delivery interval & Fetomaternal outcome.Materials and Methods: The study was carried out in the department of Obstetrics and Gynaecology at a tertiary care hospital in western India was conducted between October 2017-Jan 2019 on pregnant patients with >37 weeks of gestation after applying inclusion and exclusion criteria.Results: The study group consists of 260 subjects from urban, rural settings and different socioeconomic classes. In present study, out of total number (260) of participants, 92 (35.38%) participants had to undergo cesarean section. Out of which, 44 (33.85%) belonged to gel group while 48 (36.92%) participants belonged to insert group. This difference was not statistically significant (p=0.697). In present study, maximum number of participants (158 out of 260) delivered between 12-24 hours in both the groups. Among 158 participants, 66 (50.77%) participants of gel group while 92 (70.77%) participants of insert group delivered within 12-24 hours which was statistically significant (p <0.001). The mean induction to delivery interval was 18.07 + 7.10 hours in gel group and 15.31 + 5.44 hours in insert group which was statistically significant (p<0.001>). In present study, total of 55 (21.15%) neonates from mothers of both groups had complications, 22 (16.92%) were from insert group while 33 (25.38%) were from gel group. The difference was not statistically significant (p= 0.129). In present study, maternal complications occurred in 21(16.15%) participants of gel group and 3 (2.31%) participants of insert group which was significant statistically (p<0.001).Conclusion: The familiarity of the induction of labor and cervical ripening is slowly rising in every setting from rural to well equipped urban hospitals. The result from the present study suggests that slow release intravaginal dinoprostone insert may be effective and safe for cervical ripening and labor induction and may have several indications and advantages in obstetric care. The main disadvantage of insert is it high costs which prohibits the wider usage across the developing Indian continent.