Background: Intrauterine growth restriction (IUGR), decreased fetal movement (DFM), and oligohydramnios are conditions that can impact fetal well-being and pregnancy outcomes. Assessing blood flow parameters using Doppler studies, such as UA-PI and MCA-PI, may provide insights into fetal health. This study aimed to evaluate the Doppler changes and doppler indices in the umbilical and middle cerebral arteries and their impact on decision and mode of delivery also pregnancy outcome in cases of intrauterine growth restriction, oligohydramnios and decreased fetal movement. Methods: This prospective, observational, clinical was conducted on 50 cases (30 IUGR,10 Oligohydramnios,10 Decrease movement) and 50 control subjects. Patients then were subjected to complete history taking, obstetric history, history of the present pregnancy, general examination, abdominal examination to assess the fundal height, maternal weight and height (BMI). Ultrasound, Doppler studies carried out to assess a) Umbilical artery Doppler indices: UA-PI), umbilical artery EDV. b) Middle cerebral artery Doppler indices: MCA-PI, middle cerebral artery EDV. c) Cerebro-umbilical ratio: will be calculated as a ratio of MCA-PI / UA-PI. Results: Doppler indices UA-PI, MCA-PI, and C/U ratio demonstrated significant differences among the groups. These indices served as predictors for IUGR, oligohydramnios, and DFM. Neonatal outcomes, such as APGAR scores, birth weight, and NICU admission, exhibited variations among the groups. Conclusion: Doppler studies of UA-PI, MCA-PI, and C/U ratio offer valuable insights into the assessment of pregnancies complicated by IUGR, DFM, and oligohydramnios. These indices may serve as predictive tools for identifying fetal compromise and influencing neonatal outcomes.