Background: to evaluate the role of vaginal fluid creatinine level in diagnosis of preterm prelabour rupture of membranes among patients giving history of amniotic fluid leak. Objectives: the aim of this study was to evaluate the reliability of vaginal fluid creatinine level in the vaginal fluid for diagnosis of prelabour premature rupture of membranes. Patients and Methods: 100 pregnant women with gestational age 24: 37 weeks gestation participated in the present study divided into 2 groups. Group I (confirmed PROM group) & group II (control non-PROM group). All patients underwent a sterile speculum examination for detection of amniotic fluid pooling in the posterior vaginal fornix followed by taking 3ml from vaginal fluid. Creatinine measurement was done using ELISA. Results: The mean creatinine levels in vaginal fluid in group (I) & group (II) were.70 ± 0.88 and.04 ± 0.18 mIU/mL respectively. The difference was statistically significant (P value < 0.001). With creatinine cut-off value of 0.25 mIU/ml, the sensitivity & specificity in confirming PROM were 72 and 94% respectively. Conclusion: Creatinine level was significantly higher in pregnant women with definite PROM. Therefore, vaginal fluid creatinine can be used as an easy, rapid, reliable and non-invasive test for confirming the diagnosis of PROM and can be used as an adjunctive test in equivocal cases.