Background: Salmonella typhi and paratyphi are the causative agents of typhoid fever.  Ingestion of contaminated food and water is the root source of transmission. Typhoid is a community health challenge for India, peculiarly with the propagation of antimicrobial resistance. The goal of this study was to compare diagnostic accuracy of typhoid fever by Widal and blood culture techniques in a tertiary care center, at western Maharashtra. Material and Methods: 27750 Blood samples were withdrawn from patients, visiting Hospital from January 2015 to May 2017. Widal slide agglutination test was used for the determination of antibody titer. An antibody titer of >1/80 was taken as a cut of value to designate infection of typhoid fever. Blood culture technique was done under strict sterilization. The Central clinical laboratory provided the sufficient data regarding age and sex. Results: Out of 27750 participants, 16882(60.83%) participants were females and 10868 (39.17%) were males. 3124(11.25%) samples were found to be positive for salmonella typhi using the Widal test, blood culture method recorded 1268 (4.56%) cases. Total positive results through both the methods are 4392(15.82%). Most common age group affected was 11–30 years, 1398(27.89%) while 534 cases were seen positive via blood culture technique in the same age group. Total females 2327(8.38%), showed positivity in 1655 (5.96%) by Widal test whereas 672(2.42%) in blood culture technique. 1469 (5.29%) and 596(2.14%) were the positive findings in the males, giving a total of 2065(7.14%). The result of this study shows a significant mean difference (t–value = 2.95, p–value = 0.026) between Widal and Blood culture at 5% level of significance. Conclusion: Widal test was found to be insensitive in comparison to blood culture techniques. Therefore, it is encouraged that the presumptuously high incidence of the disease using Widal test will be significantly decreased if blood culture technique is routinely followed as a basic line of investigation in suspected cases of typhoid fever.