Objective: To compare the effectiveness of Foley catheter plus synchronous low dose misoprostol administration, with Foley catheter alone and low dose misoprostol alone on pre-induction cervical ripening within 24 hours of exposure. Methodology: The study was a prospective randomized controlled study of pregnant women with live singleton pregnancies and unfavourable cervices (Bishop score < 6) at term who presented for antenatal care and delivery at the University of Nigeria Teaching Hospital (UNTH), Ituku – Ozalla, Enugu, between 1st September, 2009 and 31st October, 2010. The women were assigned randomly by means of computer generated random numbers into Group A, where 50 women received transcervical Foley catheter (size 16F, with 30 ml balloon capacity) and synchronous administration of low dose 25µg intravaginal misoprostol (Cytotec tablets, Pfizer) every 4 hours for a maximum of 6 doses; Group B, where 45 women received transcervical Foley catheter alone for not more than 24 hours; and Group C where 45 women received low dose 25µg intravaginal misoprostol every 4 hours for a maximum of 6 doses.