According to literature, intrauterine growth retardation complicates about 5% of pregnancies and is usually caused by chronic placental insufficiency. This article reviews literature data on modern views on the issue. Special attention is paid to the role of melatonin in chronic placental insufficiency and intrauterine growth. Examples of experimental studies demonstrate successful pregnancy course and functional fetal development in animals with melatonin treatment. The data obtained by other researchers on the effect of melatonin on pregnancy, in particular, on chronic placental insufficiency in women, are analyzed. Also in this review, we suggest that melatonin, which is a powerful antioxidant, can reduce morbidity and mortality associated with intrauterine growth retardation.