Background: Automated haematology analysers offer precise haemoglobin measurements, but are expensive and impractical for field, point of care, primary care and remote settings use. The portable and cost-effective Hemocue device provides an alternative. Comparing their accuracies is crucial to prevent diagnostic discrepancies and misdiagnoses. This study aimed to determine the accuracy of Hb HemoCue machine by comparing its performance to automated analyser at Kilimanjaro Christian Medical Centre (KCMC) clinical laboratory where both equipment are used. Methodology: A cross-sectional study was conducted at KCMC Clinical Laboratory among adult patients whose haemoglobin concentrations were measured from May to June 2024. Haemoglobin levels were estimated using two distinct methods: Hb HemoCue machine and automated haematology analyser. Results: Haemoglobin (Hb) concentration values obtained from the HemoCue machine and the automated analyser, had a mean difference of 0.001 g/dL (95% Cl: