Background: Estimating fetal weight plays a crucial role in decision-making, particularly in high-risk pregnancies when determining the timing and method of delivery. In resource-limited settings where ultrasound availability is limited, Symphysio-Fundal Height and Abdominal Girth (clinical method) have been utilized as a substitute for predicting fetal weight. However, the accuracy of this clinical method has not been assessed locally. This study seeks to evaluate the precision of clinical method in estimating fetal weight and its correlation with the actual birth weight at Bugando Medical Centre. Methods: A hospital-based cross-sectional study was conducted in the Lake Zone area of Tanzania at Bugando Medical Centre. The study conveniently enrolled 400 mothers with singleton pregnancies who were admitted for normal vaginal delivery, elective cesarean section, or induction of labor. Fetal weight was estimated using clinical methods and compared with the birth weight at delivery. Statistical analysis was performed using SPSS version 20, employing descriptive statistics such as frequency, mean, and standard deviation. The relationship between estimated fetal weight, and birth weight were examined using the Chi-square and Pearson's correlation coefficient. A P-value of 0.05 was considered statistically significant. Results: The study participants had an average age of 29.13 years (± 5.346). Our analysis revealed that the mean estimated fetal weight slightly exceeded the actual birth weight, with values of 3495 grams and 3250 grams, respectively. Notably, this difference was statistically significant with a P-value < 0.001, indicating the clinical method's tendency to overestimate fetal weight. Furthermore, the clinical method showed a strong positive correlation with actual birth weight (correlation coefficient = 0.7309, p-value < 0.001), demonstrating its reliability in fetal weight estimation. The positive linear correlation between clinical fetal weight ...........