Background and objectives: Doppler velocimetry studies of placental and fetal circulation can provide an important information regarding fetal well being providing an opportunity to improve fetal outcome. The present study was undertaken to evaluate the role of fetal middle cerebral artery blood velocity waveforms, Systolic/Diastolic ratio (S/D), Pulsatility Index (PI), Resistance Index (RI) as predictor of perinatal outcome in intrauterine growth restriction (IUGR) pregnancies in IInd and IIIrd trimester. Methods: In the study group, 50 cases of IUGR were studied in IInd and IIIrd trimester. They were first subjected to ultrasonography biometry and then middle cerebral artery Doppler sonography. Results: In both control and study group the values of S/D ratio, PI and RI in middle cerebral artery decline during IInd to IIIrd trimester. The values were lower in the study group as compared to the control group. Thus the present study predicts that; a) Lower PI values were suggestive of fetal hypoxia. b) The lower values is due to vasodilatation due to hypoxia in order to supply more blood to the brain to protect it from the damaging effects of hypoxia. Thus the brain is spared from damage. Interpretation and conclusion: Doppler can be considered as one of the important non invasive technique to assess the fetomaternal and uteroplacental circulations. The middle cerebral artery indices were valuable for predicting the outcome of IUGR pregnancies.