Objectives: Primary objective was to compare screening accuracy of fetal growth assessment by conventional fundal height assessment by palpation with plotting of symphysio-fundal height (SFH) measurement on 21 ^st Intergrowth charts for detecting small for gestational age (SGA) foetuses. Secondary objective was to find an agreement between these two methods. Design: Prospective observational analytic study Setting: Lady Hardinge Medical College and associated hospitals, Delhi, India Population: Five hundred low risk pregnant women with singleton pregnancy, with reliable dates at ≥28 weeks from Antenatal Clinic of Lady Hardinge Medical College and associated hospitals from November 2019 to October 2021. Outcome measures: Assessment of fundal height in weeks by palpation and a lag of ≥3 weeks, suggested SGA fetus. SFH measured in centimetres and plotted on Intergrowth 21 ^st foetal growth charts. SFH of less than 10 ^th centile suggested SGA. Birthweight of new-born was plotted on Intergrowth 21 ^st Estimated Foetal Weight Chart. Birthweight of less than 10 ^th centile was classified as SGA. Results: Thirteen percent women delivered new-borns with birthweight below 10 ^th centile. Fundal height palpation had 98.6 % specificity and 69.9% sensitivity compared to 99.5% specificity and 83.3% sensitivity by SFH measurement for detecting SGA neonates. Conclusions: SFH measurement plotted on Intergrowth 21 ^st chart is more sensitive and specific for detecting SGA neonates compared to conventional fundal height palpation. Agreement between the methods measured by Cohen’s Kappa Statistic was 0.804, indicating substantial agreement between the methods. SFH measurement is a more accurate and practical tool, for use in low resource settings.