Background: Labor augmentation is a critical intervention to address prolonged labor, which poses significant risks to maternal and fetal health. Traditionally, oxytocin has been the primary agent for augmenting labor, but misoprostol, a prostaglandin analog, offers a potential alternative. This study aims to evaluate the efficacy, safety, and ease of application of oral misoprostol compared to intravenous oxytocin in augmenting labor among primigravid women. Materials and Methods: This prospective study was conducted at NRS Medical College and Hospital, Kolkata, from May 2011 to April 2012. A total of 100 primigravid women carrying singleton pregnancies at term with spontaneous onset of labor were enrolled. Participants were randomly assigned to two groups: one receiving oral misoprostol (25 mcg every 4 hours up to a maximum of 3 doses) and the other receiving intravenous oxytocin infusion. Key outcomes measured included augmentation-to-delivery interval, mode of delivery, neonatal APGAR scores, incidence of complications, and ease of drug application. Data were analyzed using Fisher’s exact test and chi-square test, with a significance threshold of p<0.05. Results: The average augmentation-to-delivery interval was slightly shorter in the misoprostol group (5.2 hours) compared to the oxytocin group (5.5 hours). A significantly higher number of deliveries occurred within 5 hours in the misoprostol group (68%) compared to the oxytocin group (14%) (p<0.001). The incidence of fetal distress was higher in the misoprostol group (12% vs. 2%, p<0.05), and meconium-stained liquor was more common with misoprostol (14% vs. 2%, p<0.05). Neonatal outcomes, including APGAR scores and NICU admissions, were similar between the groups, with no significant differences in the need for resuscitation or NICU admission. Ease of application favored misoprostol due to its oral administration and lack of refrigeration requirements. Conclusion: Both oral misoprostol and intravenous oxytocin effectively augment labor in primigravid women. Misoprostol offers the advantage of ease of administration and storage, but it is associated with a higher incidence of fetal distress and meconium staining. Despite these concerns, neonatal outcomes were comparable between the two groups. Further studies are needed to explore optimal dosing and minimize complications associated with misoprostol use.