INTRODUCTION: Polyhydramnios is associated with increased risk of stillbirth at term, but is historically associated with higher risk of cesarean section. The objective was to determine if induction of labor at 38-39 weeks gestation reduces the risk of cesarean compared to expectant management for women with polyhydramnios at term. METHODS: This was a single center, retrospective cohort study of singleton, vertex patients with a diagnosis of polyhydramnios at 38 weeks gestation between July 2014 and March 2018. IRB approval obtained. Women with planned induction at 38 0/7 to 39 6/7 weeks were compared to those expectantly managed. Patients with placental or uterine pathology, significant fetal anomaly, and women undergoing an induction of labor for a medical indication (e.g. diabetes, chronic hypertension) were excluded. Induction time period spanned from 38 0/7 to 39 6/7 weeks. The primary outcome was cesarean section. RESULTS: 168 singleton non-anomalous idiopathic polyhydramnios pregnancies met the inclusion criteria. 97 were induced and 71 were expectantly managed. Cesarean delivery was reduced for women induced compared to those expectantly managed (18.8% vs 35.7%, p=0.015). There were no differences in maternal or neonatal secondary outcomes. There was one case of cord prolapse and one cesarean hysterectomy in the induction group. One case of stillbirth was diagnosed in the expectant group which placental pathology revealed multiple chorangiomas and cardiomegaly on fetopsy. CONCLUSION: Induction of labor is associated with reduced risk of cesarean section in non-anomalous polyhydramnios compared to expectant management. Given the increased risk of stillbirth, induction is preferred over expectant management.