Background: The development of initiatives to lower caesarean section rates requires a fundamental understanding of the dynamics of normal and atypical labor, as well as women's behavior. Objective: The aim of the current study is to assess the predictive value of initial cervical dilatation at the time of hospital admission in nulliparous women in labor and its relation to subsequent intervention, mode of delivery, and maternal, fetal outcomes. Patients and methods: This cohort study was conducted at the Department of Obstetrics and Gynecology of both Menoufia University Hospital and Quesna General Hospital included 60 nulliparous pregnant women with singleton cephalic deliveries at 36-42 weeks who were admitted in spontaneous labor at various grades of cervical dilatation < or equal 6 cm. Results: There was a significant difference between the Average Dilatation Rate (ADR) and Initial Dilatation Rate (IDR) and the number of vaginal examinations and duration of 1^st stage and a highly significant difference in the duration of 2^nd stage. While correlating with the mode of delivery, we found that ADR is 1cm/h or more 100% in the spontaneous vaginal group and 80% in the assistant vaginal group while it is 100% less than 1cm/h in the cesarean group. IDR is 1cm/h or more in 88.6 % of the spontaneous vaginal group and less than 1cm/h in 100% of assistant vaginal and 100% of cesarean groups. Conclusion: The IDR appears to be an accurate indicator and predictor of the course of labor. When IDR was 1cm/hour or more percentage of vaginal delivery was more and if less than 1cm/hour percentage of CS was more.