The fetal heart rate acceleration response to an acoustic stimulation was compared to the traditional nonstress test in regard to pregnancy outcome, as reflected by the incidence of intrapartum fetal distress, meconium staining of the amniotic fluid, 1- and 5-minute Apgar scores, and perinatal mortality. Fetuses with spontaneous or sound-generated reactivity had comparably good outcomes with respect to all outcome measures investigated. Fetuses who lacked spontaneous or sound-stimulated reactivity had an increased risk for intrapartum fetal distress. The acoustic stimulation test is a safe and rapid test of fetoplacental sufficiency that appears to perform comparably to the nonstress test. The acoustic stimulation test significantly shortens total antepartum testing time and expense.