To evaluate the efficacy of oral misoprostol in facilitation of tandem application to the cervix during brachytherapy in patients with cervical cancer. From 2013-2019, 306 patients with cervical cancer were evaluated for cervical dilatation during brachytherapy. Patients treated with radical radiation therapy undergoing intracavitory or interstitial brachytherapy were analyzed. All patients received 200 mg of misoprostol on the day prior and on the day of the procedure before tandem application. The entire group was analyzed in terms of age, stage and size of Hegar dilators used for cervical dilatation. The complications of brachytherapy – bleeding and uterine perforations were also evaluated. Of all cases, 4% were Stage IB3, 6% were Stage IIA, 12% stage IIB, 10% stage IIIA, 29% stage IIIB, 24% stage III C, and 15 % stage IVA respectively. Mean (±SD) age (range) was 48 (25–68) years. Intracavitory brachytherapy was performed in 275 cases (90%) and Interstitial brachytherapy was performed in 31 cases (10%). Application was significantly easier in the entire group and the average size of initial Hegar dilators used for cervical dilatation was 12 Fr (4 mm) in 63.3% cases. Due the ease of insertion of uterine tandem after cervical ripening in 232(84%) patients the intracavitory applicator insertion was performed under mild sedation. There was only one case of severe cramping pain abdomen after consumption of misoprostol. In 9 cases (2.94%) cervical os was nonnegotiable despite the usage of Misoprostol,6 cases in interstitial brachytherapy and 3 in intracavitory brachytherapy. No case of heavy bleeding was noted and moderate bleeding was noted in 8.3% cases. There were 3 cases (0.98%) of uterine perforation identified on the planning CT scan. Misoprostol administration for cervical ripening before brachytherapy facilitates the procedure, increases patient tolerability and comfort, and may decrease complication rates like inadvertent uterine perforation or false tract formation. It is also cost effective as it reduced the number of cases requiring systemic or regional anesthesia.