Objective To compare the effects of misoprostol on promoting cervical maturation and delivery outcomes through different administration routes. Methods: A retrospective collection was conducted on 102 eligible parturients who visited our hospital from January 2022 to December 2024 and had the need to promote cervical maturation as the research subjects. According to the actual clinical medication routes, the patients were divided into the vaginal administration group (52 cases, 25μg vaginal tablets) and the oral administration group (50 cases, 200μg oral tablets). The effects of promoting cervical maturation, excessive uterine contractions, delivery outcomes and adverse reactions of the two groups were collected and compared. Results: The Bishop scores of both groups at 6 hours and 12 hours after medication were significantly higher than those before medication (P < 0.05); Moreover, the Bishop scores at 6 hours and 12 hours after medication and the incidence of frequent uterine contractions in the vaginal administration group were significantly higher than those in the oral administration group (P < 0.05). There was no significant difference in the time of promoting cervical maturation between the two groups (P>0.05). The time from medication to labor and the total duration of labor in the vaginal administration group were significantly shorter than those in the oral administration group, and the amount of postpartum hemorrhage was significantly less than that in the oral administration group (P < 0.05). There were no significant differences in the delivery methods, Apgar scores of newborns at 1 minute and 5 minutes after birth, and the total incidence of adverse drugs between the two groups (P>0.05). Conclusion: Although vaginal administration has more advantages in improving the score of promoting cervical maturation, there is no significant difference in the time of promoting cervical maturation between the oral administration group and the oral administration group, and the situation of excessive uterine contractions in the oral administration group is significantly lower than that in the vaginal administration group. There was no significant difference between the two administration routes in terms of delivery methods and neonatal Apgar scores, and there was no statistically significant difference in the incidence of adverse reactions.