OBJECTIVES: Labor induction has increasingly been used in the management of obstetrical care, owed to post-term pregnancies, maternal/fetal complications and voluntary election.  Several cervical ripening and induction agents are available, though failure or complications with administration of current agents are common. Induction failure generally necessitates either additional induction agents and/or an eventual cesarean section.  This analysis descriptively quantifies the economic burden associated with failed medical inductions among US Commercial and Medicaid patients.  METHODS: A retrospective analysis of inpatient hospital discharge data for 2010, using the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) was performed, to identify delivery stays with primary or secondary diagnoses of failed medical induction (ICD9 659.10-659.13). Rates of cesarean and vaginal delivery, average medical charges (converted to costs and displayed in 2010 USD) and length of stay per patient are provided. RESULTS: Failed labor induction discharges totaled 41,600 in 2010.  The average cost for a vaginal delivery (with or without complications) after failed induction was $5,890 (average charges of $17,645) this is compared to average cost of $3,860 (average charges of $10,106) for all vaginal deliveries. Hospital cost for cesareans after failed induction averaged $7,595 (average charges of $28,700) compared to $5,990 (average charges of $21,875) for all cesarean sections.  Average length of stay for failed induction with cesarean was 4.42, compared to 3.8 days with vaginal deliveries post-induction failure. CONCLUSIONS: Failed medical induction is associated with increased risk of cesarean delivery, and associated increased hospital resource use, and expenditure in delivery.  Preventing complications with induction may substantially reduce healthcare costs and resource utilization.