The majority of patients with preterm labor will deliver at term, and universal treatment of preterm labor with tocolytics and antenatal corticosteroids results in widespread overtreatment while benefitting a minority of patients. Ambulatory strategies for preventing preterm birth and identifying at-risk patients are discussed. These include consideration of obstetric history, serial cervical length sonography, digital examination, and selective use of biomarker tests. Ambulatory therapies to reduce preterm birth include different formulations of progesterone and cerclage. Optimal use of antenatal corticosteroids is discussed, and a review of ambulatory management strategies for patients who are discharged home after tocolysis is conducted.