Objective: To examine the effects of perineal massage during active labor on the frequency of episiotomy and perineal tearing. Methods: A randomized controlled study was conducted at a center in Sivas, Turkey, between January 1, 2010, and May 31, 2011. Healthy pregnant women presenting for their first or second delivery at 37-42 weeks of pregnancy were enrolled during the first stage of labor. Participants were randomly assigned (1:1) to the massage group (10-minute perineal massage with glycerol four times during the first stage and once during the second stage of labor) or control group (routine care). The frequency of episiotomy and perineal tearing were compared between the groups. Participants and investigators were not masked to group assignment. Results: Both groups contained 142 participants. Episiotomy was performed among 44(31.0%) women in the massage group and 99 (69.7%) in the control group (P = 0.001). Lacerations were recorded among 13 (42%) women in the massage group and 6 (42%) in the control group (P = 0.096). Conclusion: Application of perineal massage during active labor decreased the frequency of episiotomy procedures. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.