Our purpose was to evaluate and to compare the screening efficacy of the fetal middle cerebral artery (MCA) and umbilical artery (UA) Doppler ultrasonography for diagnosis and prediction of adverse perinatal outcome in suspected cases of intrauterine growth restriction (IUGR). Study design: The umbilical artery and fetal middle cerebral artery indices were measured in 30 fetuses suspected to have IUGR (28-36 weeks at recruitment and US-estimated weight or abdominal circumference below 10th percentile). Results: In this study, 9 cases (30%) had at least one adverse perinatal outcome. These adverse outcomes included; stillbirth, neonatal death, intubation, hypoglycemia, necrotizing enterocolitis, 5-minutes Apgar score >7, cesarean delivery for fetal distress and intensive care unit stay for more than 24 hours. The MCA indices were more sensitive but less specific in detecting the adverse perinatal outcome than the UA indices. Conclusion: Our data suggest that for management of suspected cases of IUGR, abnormal UA indices is a better predictor of perinatal morbidity and mortality than abnormal MCA indices. However, normal MCA indices may help to identify fetuses without adverse perinatal outcome.