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Abstract Background: Post-term pregnancy is associated with increased perinatal morbidity and mortality, necessitating induction of labour in many cases. The intracervical Foley catheter is a widely used mechanical method for cervical ripening, particularly in primigravida women with an unfavourable cervix. However, regional data on delivery and early neonatal outcomes remain limited. Methods: This prospective observational study was conducted at the Federal Government Polyclinic Hospital, Islamabad, including 180 post-term (≥40+0 weeks) primigravida women undergoing induction with an intracervical Foley catheter. Baseline demographics, Bishop score, and obstetric history were recorded. Outcomes assessed were mode of delivery, one-minute Apgar score (<7), and neonatal intensive care unit (NICU) admission within 24 hours. Data were analyzed using descriptive statistics and stratified by age and BMI. Results: The mean age of participants was 28.8 ± 4.7 years, mean BMI 22.2 ± 0.9 kg/m², and mean Bishop score 2.0 ± 0.4. Vaginal delivery occurred in 111 women (61.7%, 95% CI: 54.4–68.6), while 69 (38.3%, 95% CI: 31.4–45.6) required cesarean section. NICU admission was necessary for 7 neonates (3.9%, 95% CI: 1.6–7.8), and no neonate had a low Apgar score at one minute. Cesarean section rates were slightly higher among women aged 26–33 years and those with BMI 23–25 kg/m². Conclusion: Induction of labour with an intracervical Foley catheter in post-term primigravida women resulted in a favourable rate of vaginal delivery and minimal early neonatal complications. These findings support the Foley catheter as a safe and effective cervical ripening method in this high-risk population. Larger multicentre comparative studies are warranted to further define optimal induction strategies.