BackgroundThe failure of labor induction often occurs when the cervix is not ripe. To mitigate the side effects of chemical drugs, herbal medicines are now being considered for cervical ripening. This study aimed to investigate the impact of sweet almond oil vaginal suppositories on cervical ripening in nulliparous women. MethodsThis three-blinded clinical trial was conducted in 2023–2024 and involved 60 pregnant women who were referred to Shahid Hashmi-nejad Hospital in Mashhad. Women were randomly divided into two groups through a random sequence with a block size of 4, and then were given either a daily vaginal suppository of sweet almond oil or a placebo for up to one week from 40 weeks (0/7) of gestational age. The Bishop score was assessed before the intervention, 72 hours later, and four to seven days after the intervention. Data analysis was performed using SPSS 25, and the independent sample t-test, Mann-Whitney, and Wilcoxon tests were used. P value less than 0.05 was considered significant. ResultsThe intervention group and placebo group had a mean Bishop score of 1.7 ± 1.4 and 0.6 ± 0.8 respectively. After 72 hours, the mean scores for the intervention and placebo groups were 4.0 ± 2.5 and 0.9 ± 1.6, respectively and four to seven days after the intervention, the mean scores for the sweet almond oil and placebo groups were 4.5 ± 2.1 and 1.2 ± 2.1 respectively. The Mann-Whitney test demonstrated a significant difference in the Bishop scores during these three follow-ups (P < 0.001). ConclusionBased on the positive impact of sweet almond oil vaginal suppositories on increasing the Bishop score, it is recommended to utilize this affordable, safe, and accessible method for cervical ripening in nulliparous women.