Introduction: Fetal growth restriction is the second most common cause of perinatal death and the most important cause for it is utero-placental insufficiency. Utero-placental insufficiency is a process leading to progressive deterioration of placental function and a decrease in trans-placental transfer of oxygen and nutrients to fetus. Therefore early detection and treatment of utero-placental insufficiency is required. In this study we have tried to find out the effects of utero-placental insufficiency on fetus. Aims and objectives: 1. To study the risk factors and etiology of utero-placental insufficiency 2. To predict utero-placental insufficiency in high risk pregnancies 3. To study effects of utero-placental insufficiency on perinatal morbidity and mortality. Material and Method: It was an observational study, conducted at Department of Obstetrics and Gynaecology, Civil Hospital Ahmedabad from June to December, 2018. History taking, examination and Doppler study was done for each patient and patients with utero-placental insufficiency were selected. Their pregnancy outcomes, for example still births and birth weight, were noted. Results: In this study 48% of patients with utero-placental insufficiency had PIH and 10% had severe anemia. 40% patients were primi gravida. 66% patients had abnormal Doppler findings. 68% had preterm deliveries and 6% had still births or IUD.