Background: Induction of labor is a common obstetric practice aimed at reducing perinatal risks associated with prolonged pregnancy. This study aims to compare the outcomes of elective induction of labor after 39 completed weeks versus expectant management up to 41 completed weeks of pregnancy. Methods: A comparative study was conducted in the Obstetrics and Gynecology department of BSMMU, Shahbag, and Badda General Hospital, Dhaka, from January 10, 2016, to December 30, 2019. A total of 1200 prenatal patients were included, with 600 in the induction group and 600 in the expectant group. Results: The mean age was similar in both groups (30.6 years in the induction group and 30.2 years in the expectant group). Nulliparous women were more prevalent in the expectant group (56.6%) compared to the induction group (49.8%). Cervical ripening and onset of labor were higher in the induction group (71.7%) than in the expectant group (63%). The Caesarean section rate was significantly lower in the induction group (9%) compared to the expectant group (27%). Meconium-stained liquor was less common in the induction group (16.3%) versus the expectant group (22%). NICU admission rates were similar between groups, but neonatal deaths were lower in the induction group (2 vs. 13). Conclusion: Induction of labor between 39 and 40 weeks reduces perinatal mortality without increasing maternal complications, Caesarean section rates, or NICU admissions. Future research should explore induction at or beyond 37 weeks to optimize timing.