In this research article, the ANN approach was applied to analyze TFR in Sao Tome and Principe. The employed annual data covers the period 1960-2018 and the out-of-sample period ranges over the period 2019-2030. The residuals and forecast evaluation criteria (Error, MSE and MAE) of the applied model indicate that the model is stable in forecasting TFR in Sao Tome and Principe. The results of the study indicate that annual total fertility rates in Sao Tome and Principe are likely to initially rise from 4.6 births per woman in 2019 to 5.87 births per woman in 2025 and then decline to 4.42 births per woman in 2030. Therefore, the authorities in Sao Tome and Principe should focus on addressing adolescent and young adult challenges, create more demand for family planning services and channel more funds towards women empowerment program activities.