Aim: To evaluate the diagnostic performance of the Modified Bishop Score (MBS) in predicting successful vaginal delivery among term primigravida women undergoing labor induction. Methods: This prospective observational study was conducted at a tertiary care facility and included 130 term primigravida women induced with dinoprostone. Prior to induction, the MBS was recorded for each participant. Patients were followed until the mode of delivery was determined. Statistical analysis was performed using SPSS version 26, with diagnostic metrics including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy. Results: An MBS threshold of ≥6 demonstrated strong predictive value for vaginal delivery, with sensitivity of 73.2%, specificity of 89.6%, PPV of 92.3%, NPV of 66.2%, and overall accuracy of 79.2%. ROC curve analysis confirmed the score’s discriminative ability. Additionally, higher maternal age and body mass index were significantly associated with increased rates of cesarean section. Conclusion: The Modified Bishop Score is a practical, reliable, and cost-effective tool for predicting delivery outcomes in induced term pregnancies. Its high diagnostic accuracy supports its use in clinical decision-making, particularly in resource-constrained settings.