The early and accurate diagnosis of IUGR may reduce the incidence of morbidity and mortality of fetuses with this condition. Doppler velocimetry is now considered the corner stone in diagnosis and management of IUGR. Venous Doppler is now used side to side with arterial Doppler in the diagnosis and management of IUGR. The most common studied vessels are: umbilical artery and vein, middle cerebral artery and ductus venosus. To summarize, one should say that the key in management of IUGR is prompt observation and deciding the proper time of delivery of the compromised fetus according to all given data.