BACKGROUND Intrauterine Growth Restriction (IUGR) remains one of the main challenges in maternity care. Intrauterine Growth Restriction (IUGR) is commonly defined as an estimated foetal weight of less than the 10th percentile. While 70% of these are small for normal reasons and not at risk, 30% are pathologically small at risk for numerous complications including foetal death. The study was conducted with the objective to study the perinatal outcome in cases of pregnancies with intrauterine growth restriction and to determine the factors affecting their outcome. MATERIALS AND METHODS The study was conducted in 150 patients of clinically diagnosed cases of intrauterine growth restriction in the Department of Obstetrics and Gynaecology, IMCH, Kozhikode. The study was conducted during 1 year period from June 2014 to June 2015. RESULTS Most of the IUGR cases occurred in the age group of 20-34 years. Gestational hypertension is the leading risk factor. Majority of the cases with abnormal Doppler and reduced AFI had poor outcome. The perinatal outcome was good in 68.7% cases. There were 4 neonatal deaths and 2 intrauterine deaths. They had severe oligohydramnios and abnormal doppler. Among the 4 NND, three had absent diastolic flow and one had flow reversal in umbilical artery. Among the IUD, one had absent diastolic flow and one had flow reversal. CONCLUSION AFI and Doppler velocimetry are the best noninvasive tools in detecting foetal growth restriction and predicting perinatal complications, which help the obstetrician in effective antenatal management and timely intervention.