This cross-sectional study assessed knowledge and utilization of the partograph among midwives in two tertiary health facilities in the Niger Delta Region of Nigeria. A descriptive survey design was utilized, using a structured questionnaire administered to 165 midwives purposively selected from the Federal Medical Center (FMC) (79) and Niger Delta University Teaching Hospital (NDUTH) (86). Results revealed that 84% of midwives knew what the partograph was and 92.7% indicated that the use of the partograph reduces maternal and child mortality. About 50.6% midwives in FMC and 98.8% in NDUTH indicated that it was routinely utilized in their centers. Assessment of utilized partograph charts revealed that only 18 (37.5%) out of 48 in FMC and 17 (32.6%) out of 52 in NDUTH were properly filled. Factors in the utilization of the partograph were:-non-availability of the partograph (30.3%), shortage of staff (19.4%), little or no knowledge in the use of the partograph (22.2%), and 8.6 percent indicated it was time consuming. A significant relationship existed between knowledge of the partograph and its utilization (chi2 = 32.298. Df = 1; P < 0.05) and between midwives years of experience and its utilization (chi2 = 4.818, Df = 4; P < 0.05). However, this study also showed that despite midwives good knowledge of the partograph, there was poor utilization in labor monitoring in both centers. Training of midwives on the use of the partograph with periodic workshops and seminars and a mandatory hospital policy are recommended and vital to the safety of women in labor in the Niger Delta region of Nigeria.