Background: Zambia has seen a decline of maternal mortality rate (MMR) from 213 per 100,000 live births to 183 per 100,000 live births and the infant mortality rate (IMR) from 45 per 1,000 live births to 43 per 1,000 live births (United Nations, 2020). In spite of this, the ministry of health (MoH) has continued advocating for the use of the partograph in preventing negative birth outcomes. Nevertheless, most available research nationally and internationaly show that it is unclear whether there is a relationship between utilisation of the partograph and birth outcomes. Objective: The study aimed at investigating the relationship between utilisation of the partograph and birth outcomes. Methods and Materials: A cross-sectional quantitative study design was used. The systematic random sampling was used to select 183 partographs and convenience sampling was used to select 20 midwives. The materials used were self-administered questionnaire/ partograph checklists, Statistical Package for Social Sciences (SPSS) version 22 and the Chi square test. Results: The study has indicated that use of the partograph in monitoring women in labour has the potential to influence birth outcome which could be appropriate or inappropriate. The cross tabulation showed no correlation between utilisation of the partograph birth outcomes as most partographs with bad utilisation still had a p value of 0.045. Conclusion: There is no relationship between utilisation of the partograph and birth outcomes.