Objectives The present study was conducted to compare the gravidogram and ultrasound in the detection of intrauterine growth restriction. Methods This study was conducted in the Department of Obstetrics and Gynecology, Voluntary Health Services, Chennai (TN) from August 2007-May 2009. The study included 321 women with singleton pregnancy in a longitudinal lie. These women underwent serial symphysiofundal height measurements and ultrasound. Birth weights of the newborns were noted at the time of delivery. Gravidogram and ultrasound findings were correlated with the birth weights. Results The sensitivity of the ultrasound in the detection of IUGR was higher (85.2 vs 74.1 %) than the gravidogram, but the specificity was almost the same (96.6 and 95.9 %). Conclusions The gravidogram is a simple and inexpensive screening tool and as useful as an ultrasound in detection of intrauterine growth restriction. Both gravidogram and ultrasound, when used together, have higher detection rates.