To evaluate the value of ultrasound in the diagnosis and management strategies of intrauterine growth retardation. A descriptive study. Radiology Department, Aga Khan University Hospital, Karachi, from April 1998 to August 1999. The study population comprised of 206 subjects evaluated for suspected intrauterine growth retardation. Grey scale as well as Doppler ultrasound findings were evaluated and compared against post-natal outcome. One hundred and eight out of 206 subjects showed positive imaging results with 40 false positive and 20 false negative subjects. The sensitivity, specificity, positive predictive and negative predictive values were 77.8%, 66.1%, 55.6%, and 45.1% respectively. Forty subjects showed false positive results on imaging (low biophysical profile score and Grey scale biometry discrepancy) while 20 of the subjects showed false negative results (normal on US imaging) when compared with postnatal neonatal body weight criteria. Twenty-two subjects had oligohydramnios with amniotic fluid index below 5 percentile for their respective gestational ages (20%) out of 108. Obstetric and Doppler ultrasound is an accurate method for diagnosis and management of fetal growth retardation.