Introductions: The term macrosomia is used to describe a newborn with an excessive birth 
weight. A diagnosis of fetal macrosomia can be made only by measuring birth weight after 
delivery; therefore, the condition is confirmed only retrospectively, ie, after delivery of the 
neonate. Fetal macrosomia has been defined in several different ways, including birth weight 
greater than 4000-4500 g or greater than 90% for gestational age. Aim of Study: Assessment 
of prevalence of fetal macrosomia and accuracy of its diagnostic tools in Minia Maternity 
University Hospital. Patients and Methods: Design of work: In our Cross sectional 
observational study 208 recruited women who were admitted to our hospital for CS indicated 
by prenatal diagnosis of fetal macrosomia .Complete evaluation of all our cases was done and 
fetal weight was assessed clinically and by ultrasou .Results: Prevalance of fetal macrosomia 
was high in Minia maternity hospital and Ultrasound evaluation of fetal weight showed better 
performance than the clinical method regarding absolute errors and error percentages. 
Ultrasound assessment had higher sensitivity and specificity in detecting fetal weight.
Conclusion: The prevalence of fetal macrosomia at MMH was 5.5% Sonographic evaluation 
of fetal weight displayed superiority than the clinical approach as regards absolute errors and 
error percentages.