Objective: To compare the efficacy of vaginal misoprostol and prostaglandin E2 in induction of labour in primigravidae. Material Method:The study was conducted in the department of Obstetrics and gynaecology ward 8 from 1st January, 2006 to 31stDecember, 2006 at Jinnah Postgraduate medical center Karachi. It was a comparative clinical trial in which 100 primigravidae at term (37-42 weeks) were included in whom induction of labour was indicated and proforma was used for data collection. Results: Hundred primigravidae were studied, 50 women were given misoprostol while the other 50 were given prostaglandin E2. The patients were induced with the Bishop score of 4 or less, the mean induction to delivery interval was 10.96± hours in misoprostol group and 13.06± hours in PGE2 group. 44% of patients required oxytocin for augmentation of labour in misoprostol group 70% required in PGE2 group. Vaginal deliveries were 94% in misoprostol group where as 74% in PGE2 group.The cesarean section rate was 6% in misoprostol group while 26% in PGE2 group.There was no significant difference in the Apgar score and neonatal deaths in both groups Conclusion: Misoprostol is a cost effective, less expensive agent. It is significantly more effective for labour induction and cervical ripening than PGE2. There is a reduction in the induction to delivery interval and cesarean section rate. And there was no evidence of harm either to the mother or the new born in substantive outcome.