Background: Premature rupture of membranes (PROM) is preterm (PPROM) when it occurs before 37 weeks gestation. It is a complication of 2% to 20% of all deliveries and is a known important contributor to maternal and perinatal morbidity and perinatal mortality. Objective: To assess the accuracy of the uses of insulin-like growth factor binding protein-1 (IGFBP-1) in prediction of preterm premature rupture of membranes. Patients and Methods: This comparative cross sectional study included 90 pregnant women between 28-36 weeks of gestation complaining of watery vaginal discharge, carried out at Sayed Galal hospital, Al-Azhar University between August, 2018 and August, 2020. Results: This study showed no statistically significant differences regarding maternal age, parity and gestational age at recruitment.IGFBP-1 (Actim PROM test) was more sensitive and specific in diagnosing rupture of membranes than Nitrazine test. The sensitivity and the specificity of IGFBP-1 (Actim PROM test) in diagnosing PROM was 89.7% and 86.9% respectively as compared to Nitrazine test which was 75.9% and 82.0%. The PPV and NPV of IGFBP-1 were 76.5% and 94.6% as compared to Nitrazinet test which were 66.7% and 87.7%. Conclusion: One step cervicovaginal IGFBP-1 (Actim PROM) dipstick was a rapid reliable, non-invasive, easy and accurate diagnostic test for PROM.