Background: Bacterial vaginosis (BV) is a clinical entity that is characterized by a change in vaginal ecology where the normal flora lactobacillus morphotype is replaced by a mixed microbial consisting of anaerobes, gardnerella vaginalis, mycoplasma hominis. It appears to be particularly common in sub-Sahara Africa but no ideal diagnostic method has been found. Objective: The objective of this study was to determine the accuracy of the Nugent scoring and gardnerella vaginalis culture in the diagnosis of bacterial vaginosis among pregnant women attending antenatal clinic in NAUTH. Study design: A descriptive cross-sectional study Subjects: A total of three hundred and thirty-three (333) antenatal women at the gestational ages of 16-28 weeks regardless of symptoms who satisfied the inclusion criteria were recruited in this study that was carried out between March and August, 2011 at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi. Method: Socio-demographic characteristics, past reproductive, social, sexual health history and vaginal hygienic practices of the enrolled pregnant women were obtained by questionnaire. Pelvic examination was performed on each patient and samples of vaginal discharge tested for BV infection using Amsel’s criteria, Nugent’s score and culture of G. Vaginalis. Interpretation was made blindly without knowledge of each test result. Using Amsel’s criteria as a ‘gold standard’, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of both Nugent’s score and culture of G. vaginalis were estimated. Data and statistical analysis: Data were entered and analysed using Epi-Info 2008 version 3.5.1. Proportions were compared by Chi-square where appropriate and the statistical significance of P- value was <0.05.