Objective: This study aimed to analyze the role of epidural anesthesia in alleviating labor pain, while assessing its influence on labor progression, maternal satisfaction, and neonatal well-being. Methodology: This prospective cohort study was conducted at a tertiary care hospital over a period of six months. A total of 200 pregnant women in their third trimester, aged 20 to 45 years, who opted for epidural anesthesia during labor, were included in the study. The control group consisted of 200 women who delivered without epidural analgesia. Data were collected on labor progression, delivery method, maternal complications (such as hypotension and backache), neonatal outcomes (such as Apgar scores), and patient satisfaction. Statistical analysis was performed using descriptive and inferential methods, including chi-square tests and independent t-tests, to compare the outcomes between the two groups. Results: The study found that 75% of women in the epidural group reported complete pain relief, significantly higher than the 30% in the non-epidural group (p < 0.05). However, the duration of the first and second stages of labor was significantly longer in the epidural group, with the first stage averaging 6.5 hours compared to 5.8 hours in the non-epidural group (p < 0.05). Additionally, the rate of instrumental deliveries was higher in the epidural group (25%) compared to the non-epidural group (15%) (p < 0.05). Neonatal outcomes, including Apgar scores, were similar between the two groups, with no significant differences in breastfeeding initiation rates. Maternal complications, including hypotension and backache, were observed more frequently in the epidural group, although these were managed effectively. Conclusion: Epidural anesthesia proved to be an effective method for pain relief during labor, with most women reporting significant pain alleviation. However, it was associated with prolonged labor, increased instrumental deliveries, and maternal complications such as hypotension. Despite these challenges, neonatal outcomes were not adversely affected, and the overall safety profile of epidural anesthesia was favorable. These findings underscore the importance of careful management and monitoring during labor to minimize the risks associated with epidural analgesia.