The failure of a fetus to achieve its optimal growth potential is classified as fetal growth restriction (FGR). Small fetuses are a major risk for adverse perinatal outcomes including perinatal mortality, perinatal brain injury, and fetal distress compared to fetuses with normal growth.[1] [2] [3] [4] [5] FGR is considered as a fetus with an estimated fetal weight (EFW) less than 10th percentile. However, FGR also shows Doppler signs of hemodynamic redistribution as a fetal adaptation response to undernutrition or hypoxia and histological and biochemical signs of placental disease.[1] Small for gestational age (SGA) fetuses, on the other hand, are defined as constitutionally small fetuses without evidence for fetal adaptation to abnormal fetal environment and have perinatal outcomes similar to fetuses with normal growth.[1] Samrakshan, a national program of Indian Radiological and Imaging Association (IRIA), integrated trimester-specific Doppler studies with routine antenatal ultrasound assessments.[6] We present the results pertaining to the prevalence of FGR and SGA identified through the Samrakshan program.