Objective: To compare the safety and efficacy of low dose misoprostol by oral and vaginal routes for induction of labor. Study Design: Quasi Experimental Setting: Department of Gynecology and Obstetrics Jinnah Medical and Dental College Hospital, Korangi Industrial Area Karachi from 01-September-2010 to 28-February-2011. Methods: Total 100 patients, fulfilling the inclusion criteria for induction of labour, were selected by using non probability convenient sampling technique. They were divided into two groups, 50 patients in each vaginal and oral group and were given 50 microgram of misoprostol six hourly till bishop score improved. Maximum of 3 doses were given and results were analyzed through SPSS version 17. Results: Statistically there was not much difference observed in maternal age, gestational age, parity, induction delivery interval and number of doses required. The most significant difference was found in the mode of delivery as caesarean section rate [15 (30%) p-value 0.02] was higher in the oral group. Besides, meconium stained liquor [20 (40%) p-value 0.001] and the fetal distress [13 (26%) p-value 0.220] were also found to be higher in the oral group. In terms of maternal complication there was much difference in nausea, vomitting [21 (42%) p-value 0.009], diarrhea [14 (28%) p-value 0.003] and fever with shivering [5 (10%) p value 0.999] in the oral group. Conclusion: Vaginal group is found to be safer than the oral group. Although misoprostol is equally effective in both oral and vaginal groups, however it is the safety consideration which gives primacy to the vaginal group as compared to the oral group.