To examine the association between sonographic fetal head position before labour induction and outcome of induction of labour, specifically left occipito-anterior (LOA) and occiput posterior (OP) fetal position and vaginal delivery within 24 hours. This is a retrospective cohort study retrieved data from a computerized database for previous clinical trials using a prospectively determined method of induction. The study cohort consisted of 371 women with singleton pregnancies who were scheduled for induction of labour at ≥ 37 weeks. Immediately before induction, all women enrolled in this study underwent a transabdominal ultrasound to determine fetal occiput position. The clinical parameters studied were maternal age, height, weight, fetal gender, cervical length, Bishop score and birthweight. Primary outcome measure was vaginal delivery within 24 hours and secondary outcome included mode of delivery. Successful vaginal delivery occurred in 310 of the 371 (83.5%) women and this was within 24 hours of induction in 253 (68.1%) women. Univariate and multivariate analyses showed no evidence of difference in odds ratio (OR) of vaginal delivery within 24 hours for fetuses in the LOA position when compared with all other positions. Similarly, there is no evidence of the OP position being associated with vaginal delivery within 24 hours. However, logistic regression indicated that maternal weight, cervical length and Bishop score were independent predictors of vaginal delivery within 24 hours. In terms of the likelihood of Caesarean delivery as the outcome variable, very similar results of univariate and multivariate analyses were obtained. Our study showed that LOA and OP position before induction of labour do not appear to be associated with outcome of induction of labour. Therefore, in clinical practice, ultrasonography for assessing fetal position before induction has a limited value in predicting outcome of labour induction.