Background: This hospital based prospective comparative study was conducted at Obstetrics and Gynaecology department, tertiary care hospital, to compare the veracity of clinical and ultrasonographic estimation of fetal weight at term with actual birth weight. Methods: this is an hospital based prospective comparative study. Study population includes antenatal women who were admitted in labour room of Obstetrics and gynaecology department of tertiary care hospital from July 2023 to September 2023. All antenatal women with term gestation between 37 weeks to 42 weeks, singleton pregnancy with Vertex presentation, who had gestational age confirmed by dates and ultrasound scanning of <22weeks and those whose amniotic fluid index were found between 5 to 25cms were included in the study. Patients with polyhydraminos, oligohydraminos, Antepartum haemorrhage, Congenital anomalies of fetus, Obese women with body mass index of >30 kilogram/meter ², women with Ruptured membranes, with Intrauterine death and women with uterine/Abdominal mass were excluded from the study. Fetal birth weight was estimated by clinical and ultrasonographic method. Birth weight after delivery was recorded in grams by electronic weighing machine and tabulated. Results: Both ultrasonographic and clinical methods of fetal weight estimation has positive correlation with actual birth weight. Both have more sensitivity with normal birth weight group of 2500-4000grams. The overall mean absolute percentage error of clinical method (7.2+/-7.7) was smaller than that of ultrasonographic method (16.2+/-11.1). In low birth weight group, mean absolute percentage error was (9.0+/-11.3) with ultrasonographic estimation and was (11.7+/-9.0)with clinical method of fetal weight estimation. No statistically significant difference was observed among these two methods. Conclusions: The present study concluded that clinical estimation of birth weight is as accurate as routine ultrasonographic estimation. Clinical palpation should be considered as diagnostic tool for fetal weight estimation and is equally reliable, cost effective and easy to teach and learn. Need is to practically apply method, so as to guide the management decisions.