Accurate evaluation of foundation stress and bearing capacity is essential for ensuring the structural integrity of critical infrastructure, particularly in large-scale hydropower projects featuring open powerhouses. These structures are subjected to significant forces and moments about horizontal orthogonal axes, requiring careful consideration of eccentric loading effects to guarantee stability. Although Meyerhof’s theory is commonly employed for such assessments, empirical evidence from constructed projects and research studies indicates limitations, including potential non-conservatism in certain scenarios. This study investigates a hydropower foundation in Rwanda, Africa, utilizing nonlinear finite element analysis to assess foundation stress under eccentric loading conditions. The numerical results are compared with theoretical predictions derived from Meyerhof’s method, revealing that while the theory is often regarded as conservative, it may fail to adequately account for localized yielding in open powerhouse foundations, potentially leading to unsafe design outcomes. The findings underscore the importance of supplementing theoretical approaches with advanced numerical simulations or experimental validation in high-stakes engineering applications.