Objective. The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to evaluate the efficacy and safety of the FC compared to oral misoprostol for cervical ripening after PROM. Design. A retrospective data-analysis. Setting. Two Dutch teaching hospitals. Population. 128 pregnant women underwent cervical ripening after ≥ 24 hours of PROM at 37-42 weeks’ of gestation. Main outcome measures. The incidence of intrapartum infection, as a composite of maternal and neonatal infection. In addition, we evaluated the mode of delivery, duration of priming and priming-to-delivery interval. Results. The incidence of intrapartum infection was higher in the FC group compared to oral misoprostol, respectively 32.7% (n = 16) vs. 12.7% (n = 10) (p = .006). However, after adjusting for epidural anaesthesia and pregestational BMI, the association was no longer significant. No difference was found in mode of delivery. The total priming-to-delivery interval was similar in both groups (median 21.3 hour vs. 22.0, p = .897). The duration of cervical ripening was shorter in the misoprostol group and duration of active labour longer (p <.001). Conclusion. In women who require cervical ripening after prolonged PROM at term, FC and oral misoprostol are similar in terms of efficacy and safety. Funding. The authors received no financial support.