Objectives: The purpose of this study was to test the association between elective induction of labor and cesarean delivery and to determine maternal and neonatal outcomes in elective induction of labor. Materials and methods: We conducted a retrospective matched cohort study in a tertiary care hospital from January 2014 to December 2015, among 182 nulliparous women at gestational age of 39^0/7 weeks or more who had single live pregnancy with known cervical status of ≥5 at 38^0/7 to 38^6/7 weeks and were managed either by elective induction or expectant management. Data were compared using χ² and Student's t-test, and p < 0.05 was considered significant. Results: The cesarean delivery rate was 51% in expectant and 46.8% in elective induction group, which was not much different. Women who were electively induced spent more time in labor delivery unit (14 hours, 21 minutes vs 12 hours, 45 minutes, p < 0.01), had labor longer than 12 hours (50 vs 36.5%, p = 0.05), received more frequently oxytocin (63.5 vs 47.9%, p = 0.03), and were more likely to deliver during daytime between 6.00 am and 6.00 pm (64.5 vs 52%, p = 0.07) compared with expectant group. There were no difference with regard to obstetric events and maternal neonatal outcomes. Conclusion: Elective induction did not result in increased risk of cesarean delivery in nulliparous women with unfavorable cervix. It is relatively safe as we had observed no evidence of any other increased adverse maternal or neonatal outcomes with elective induction.