Background: Modern obstetrics aims at improving the safety of the mother and the fetus during antenatal period as well as parturition. When the risks of continuation of pregnancy either to mother or to fetus is more the induction of labor is indicated [1]. The aim of induction of labor is to perform safe vaginal delivery before term. Objectives: Induction of labor with Dinoprostone gel (PGE2) and measuring its effect on fetal and maternal morbidity and mortality and to study the percentage of vaginal delivery verses caesareansection after induction with Dinoprostone gel. Methods: A Clinical hospital based case control study done in pregnant women full filling inclusion criteria and excluding certain exclusion criteria’s, primigravidas with singleton pregnancy beyond 35 weeks of gestation and with Bishop score of less than 5were selected and study was conducted in labor Room of Department of Obstetrics and Gynecology, Kamla Raja Hospital, G.R. Medical College & J.A. Group of Hospitals, Gwalior (M.P). A Total sample size of 100 study cases and 100 control cases were taken for two years duration. Result: In this study there was a significant difference in mode of delivery in both groups .In case group there was more number of newborn required NICU admission (39%).Apgar score at 5 min was < 7 in 35% cases in case group while 30% in control group. There was more number of maternal complication seen in case group, PPH was 20% in case group as compared to 18% in control group .In case group , 81% cases delivered vaginally and 19 cases required cesarean section , while 91% in control group delivered vaginally and only 9 control cases required cesarean section. Conclusion: The present study shows that Dinoprostone gel is effective in improving Bishops score, also improvement in the Bishops score is dependent on the pre – induction Bishops score. Although the vaginal delivered patients were more in control group. The cesarean section rate is increased in induction group cases. IOL is associated with a significantly increased risk of cesarean delivery in nulliparous women. The decisions to undertaken IOL need to be clear and clinically justified.