Background and objectives: Early identification of postures and movements possibly associated with a poorer quality of developmental outcome is very desirable. Assessment of gestational age of the infant help to identify the developmental status of the infant . One of the widely used tools in gestational age assessment is the scarf sign . Recently, a new method of measuring scarf sign called scarf ratio was described. This scale being relatively new , the available literature reflects a need for estimating intrarater and interrater reliability of scarf ratio., Subjects and measurments : Thirty two preterm infants recruited from neonatal ICU at district maternity hospital who met the inclusion & exclusion criteria were examined to estimate interrater and intrarater reliability of scarf ratio . Intrarater reliability for scarf ratio was estimated with a second assessment following a brief interval. Simultaneously, interrater reliability of scarf ratio was estimated with second therapist, Conclusions : Scarf ratio can be used as an efficient individual tool to estimate gestational age in preterm infants. It is also a reliable measure when conducted by two different clinicians who are well versed with the method. 

Key words: Preterm infants, Gestational age assessment, scarf sign , scarf ratio.