Dissertation (MMed Obstetrics and Gynecology)Introduction: Properfilling of partograph improve the quality of obstetric care through early detection of labor related complications and hence reduce maternal and neonatal complications.Appropriate utilization of partograph during labor can significantly reduce the rate of maternal mortality related to labor and delivery. Objective:The aim of the study was to assess the level of partograph completeness and associated obstetric outcome among prime gravida in active stage of labor at Iringa Referral Regional Hospital. Methods:The study was ahospital based cross- sectional study design,which involved the partograph of primegravida women during the study duration from January –March 2019.The pretested structured checklist was used to gather the required data soon after delivery. Analysis of the collected data was done using STATAversion 13, descriptive statistics was done to explore the extent of partograpgh completeness, Chi- square was used to find out an association between dependent and independent variable. Binary logistic regression was made to obtain odds ratio (OR) and confidence interval (CI) where P< 0.05 considered statistically significant. Results:The level of completeness of partograph was 5.4% at Iringa Regional Referral Hospital for primegravida women. Cervical dilatation, fetal heart rate, descent of the presenting part and contractions were filled better 73.4%, 73%,72.1% and 71.8% respectively than maternal blood pressure 33.9 There was a significant association between incomplete partograph completeness with immediate maternal and neonatal adverse outcome(OR 2.9, P value 0.017 and OR 4.5,P value 0.04 respectively with 95% CI). Conclusion:There is a poor completion of partograph during labor for prime gravida women at Iringa Referral Regional Hospital. The level of completeness of partograph is associated with adverse maternal and perinatal outcome. In order to improve the level of partograph completeness strong supervision and positive attitude towards partograph should be enhanced.