Background: The significance of premature birth cannot be underestimated. Being born too early is the major cause of perinatal morbidity and mortality accounting for 85 percent of all early infant deaths, not secondary to congenital abnormality. Objective: To compare between the efficacy of progesterone and ritodrine (beta-sympathomimetic) in the management of threatened preterm labour. Patients and methods: In the present study we aimed to compare between the efficacy of progesterone and Ritodrine (beta-sympathomimetic) in the management of threatened preterm labor on 100 females presenting with preterm labour, randomized into two groups using simple randomization, where 50 patients received Ritodrine and 50 patients received progesterone. Results: The success rate of the drugs to delay delivery more than 48h there was 72% in Ritodrine group and 38% in progesterone group with a statistically significant difference between the two study groups. There was a statistically significant difference in neonatal weight at delivery and neonatal intensive care unit (NICU) admission between the two study groups, which may be related to gestational age at delivery that has shown significant difference between the two study groups. Conclusion: The success rate of Ritodrine to prevent preterm delivery was better than Progesterone, but the side effects were more serious. Therefore, we recommend starting tocolysis with Ritodrine within the first 48 hours, then to continue with progesterone to avoid the undesirable side effects of Ritodrine.