Background: Preterm birth continues to be a problem for obstetricians. Preterm birth complicates 8-10% of birth. Although the causes of preterm labor are not well understood, the burden of preterm birth is clear. Aim and objectives: The aim was to study to evaluate the efficacy and safety of transdermal nitroglycerin as tocolytic agent in women with preterm labor. Subjects and methods: This prospective randomized controlled trial was conducted in obstetrics and Gynecology department, AL- HUSSIEN University Hospital. The study was carried out on total of 100 patients with preterm labour. They were randomly assigned to either the nitroglycerine patch or bed rest alone. The duration of the study ranged from 6- 12 months. Results: out of 50 women in the TNG group, a total of 47 (94.0%) women benefited from the GTN patch and the labor pains stopped within the first few hours. Only 3 (6.0%) patients could not go beyond 48 hours. Delivery was deferred for 48 to less than 72 hours, 72 to <96 hours, 96 to < 7days and more than 7 days in 4(8.0%), 11(22.0%), 4(8.0%) and 28(56.0%) respectively. Conclusion: TNG appear to be at least as effective as the commonly used tocolytics today.