Objective <p>To compare the efficacy and side effects of Foley balloon catheter with intracervical dinoprostone gel in nulliparous women undergoing induction of labor.</p> Study Design <p>A randomized comparative study was carried out in tertiary care hospital over a 18-month period.</p> Methods <p>Randomized controlled study in which 240-women who required induction of labor were randomized into two groups: Group 1—Foley catheter, Group 2—Prostaglandin E2 intracervical (PGE2) gel. Induction delivery interval (IDI), side effects, complications, and neonatal outcomes were compared in both the groups.</p> Results <p>Induction delivery interval (<i>p</i> value = 0.466) was similar in both the groups. There was significant difference in terms of final Bishop score (<i>p</i> value &lt; 0.001), induction to spontaneous rupture of membrane (<i>p</i> value &lt; 0.001), and duration of oxytocin administration (p value = 0.005). Mode of delivery was comparable in both the groups in terms of normal vaginal delivery (<i>p</i> value = 0.666) and LSCS (<i>p</i> value = 0.390). Both the groups had minimal side effects. Neonatal outcomes in terms of APGAR score (<i>P</i> value = 0.421) and NICU admission (<i>p</i> value = 1.000) were also comparable in both the groups.</p> Conclusion <p>The study concluded that extra amniotic Foley balloon catheter is an effective, safe, simple, reversible, non-pharmacological mechanical method of preinduction cervical ripening in nulliparous women.</p>