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Routine biometry was recorded and estimated fetal weight (<jats:styled-content style=\"fixed-case\">EFW<\/jats:styled-content>) calculated using 33 different formulae. Only pregnancies that delivered within 48\u2009h of the ultrasound scan were included (4280 singleton and 586 twin fetuses). Differences between the <jats:styled-content style=\"fixed-case\">EFW<\/jats:styled-content> and actual birth weight (<jats:styled-content style=\"fixed-case\">ABW<\/jats:styled-content>) were assessed by percentage error, accuracy in predictions within \u00b1\u200910\u2009% and \u00b1\u200915% of error and use of the Bland\u2013Altman method. The accuracy of prediction of the different cut\u2010offs of birth\u2010weight discordance in twin pregnancies was also assessed using the area under the receiver\u2013operating characteristics curve (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall mean absolute percentage error was\u2009\u2264\u200910\u2009% for 25 formulae in singleton pregnancies compared with three formulae in twin pregnancies. The overall predictions within \u00b1\u200910% and \u00b1\u200915% of the <jats:styled-content style=\"fixed-case\">ABW<\/jats:styled-content> were 62.2% and 81.5% in singleton and 49.7% and 68.5% in twin pregnancies, respectively. When the formulae were categorized according to the biometric parameters included, those based on a combination of head, abdomen and femur measurements showed the lowest mean absolute percentage error, in both singleton and twin pregnancies. The predictive accuracy for 25% birth\u2010weight discordance using the Hadlock 2 formula, as assessed by the <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>, was 0.87.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ultrasound estimation of birth weight is less accurate in twin than in singleton pregnancies. Formulae that include a combination of head, abdomen and femur measurements perform best in both singleton and twin pregnancies. Copyright \u00a9 2013 ISUOG. 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