Intrauterine growth retardation affects approximately 10% of live-born infants. Causes of intrauterine growth retardation are heterogeneous, and frequently the care of these infants poses a diagnostic and therapeutic challenge. Diagnosis of impaired fetal growth is an area in which close collaboration among the obstetrician, pediatrician, and dysmorphologist is essential for proper care of these newborns. It is axiomatic that the best way to care for these infants is to establish an accurate diagnosis prenatally or soon after birth and to manage on that basis. An algorithm for evaluation and management of intrauterine growth retardation that is based on available empiric data is presented. These guidelines are intended to guide medical practice and not to replace clinical judgment.