Our Modified Gravity Theory (MOG) is a gravitational theory without exotic dark matter, based on an action principle. MOG has been used successfully tomodel astrophysical phenomena, such as galaxy rotation curves, galaxy cluster masses and lensing. MOG may also be able to account for cosmological observations. We assume that the MOG point source solution can be used to describe extended distributions of matter via an appropriately modified Poisson equation. We use this result to model perturbation growth in MOG and find that it agrees well with the observed matter power spectrum at present. As the resolution of the power spectrum improves with increasing survey size, however, significant differences emerge between the predictions of MOG and the standard Λ-cold dark matter (Λ-CDM) model, as in the absence of exotic darkmatter, oscillations of the power spectrum in MOG are not suppressed. We can also use MOG to model the acoustic power spectrum of the cosmic microwave background. A suitably adapted semi-analytical model offers a first indication that MOG may pass this test and correctly model the peak of the acoustic spectrum.