Introduction: Prolonged labor have been associated with increased fetal and maternal morbidity and mortality; therefore, it is essential to identify women who are at risk of dystocia and to choose the most appropriate way of delivery at an early stage in pregnancy. X-ray pelvimetry has thus been used to identify women at risk of dystocia especially in rural health facilities of developing countries such as Uganda. However, there is still a need to review how this practice is useful in predicting the outcome of labor, and whether or not its continued use is sustained or discouraged. Material and methods: This was a retrospective study on 200 patients at near term or in early stages of labour who had undergone X-ray pelvimetry at Mbarara Regional Referral Hospital, Western Uganda. The pelvic dimensions including anteroposterior and transverse diameters of the pelvic inlet and pelvic outlet diameters were analyzed against the expected and final modes of delivery. Results: The average antero-posterior diameter of the pelvic outlet was 12.95 ±0.95 whilst that of the transverse diameter was14 ±0.6 cm. Of all the cases, 80% (160/200) had large pelvic inlet however 20.6% (33/160) still underwent caesarian section. The average pelvic outlet diameter was 8.4±0.4 cm. Discussion and conclusion: In this study, pelvimetry has shown to increase the chances of caesarian section. However, its value in early detection of obstetric complications is well appreciated.