Background: Intrapartum head circumference is an integral part of sonographic models and important for the purpose of fetal weight estimation as well as in cases which abnormal fetal head growth is suspected, it is considered the interface between maternal pelvis and fetus. Aim: This study aims to assess the accuracy of fetal head circumference compared to expected fetal weight as a predictor of spontaneous vaginal delivery Methods: A prospective observational study was conducted on 996 women in active stage of labor admitted to Labor ward of Ain Shams University Maternity Hospital and Labor ward in Manshiet El Bakry general hospital. Results large head circumference (odds ratio, 2.8; 95% CI, 1.37–5.73; p-value; .005  was independent predictors for cesarean delivery, and no significant difference on mode of delivery between different expected fetal weight, Conclusion: A large head circumference is more strongly associated with unplanned caesarian section than high expected fetal weight.