Oligohydramnios is a severe and common complication of pregnancy. The finding of oligohydramnios can be associated with fetal anomalies, PROM, uteroplacental insufficiency (eg, growth retardation, postdatism, abruptio placenta, significant maternal illness), abnormalities of twinning, and idiopathic oligohydramnios. Ultrasound detection of this complication should prompt the clinician to thoroughly evaluate the gravida for hypertension, diabetes, or other significant illness. In addition, a thorough fetal anatomic survey focusing on the genitourinary tract and an attempt at visualizing free amniotic bands should be performed with ultrasound. Karyotype should be considered. The role of amnioinfusion to assist in diagnosis should be considered. Once diagnosed, oligohydramnios with or without associated conditions should lead to intensive fetal biophysical surveillance including frequent ultrasound evaluation. Delivery in the term patients must be considered. The role of amnioinfusion as an adjunct to continuous fetal monitoring in labor to improve neonatal outcome appears beneficial in select series. The role of repetitive amnioinfusion in the preterm patient remote from term may offer marginal clinical benefit to neonatal outcome and is considered experimental at this time.