Intrauterine Growth Restriction is one of the major factors in perinatalmorbidity and mortality. Routine antenatal care focuses on the detection of women atincreased risk, aiming at careful monitoring and appropriate intervention. Although theseproblem manifests in the second half of pregnancy and most research has been employedaccordingly, there is evidence that they are associated with events taking place in the firsttrimester of pregnancy.In the first trimester of pregnancy the placentally derived biochemical markers(Pregnancy Associated Plasma Protein-A and free beta hCG) are increasingly being usedin conjunction with the ultrasound measurement of nuchal translucency as part ofscreening programs for trisomy 21 and other aneuploidies. Approximately 90 percentageof such anomalies can be identified with a false positive rate of 5%. Preliminary studieshave shown that reduced levels of these biochemical markers particularly PAPP-A may beof potential value in identifying those pregnancies that may result in adverse outcomeincluding the delivery of small for gestational age. Aims and Objectives: To determine the association of maternal serum biochemical markers with adversepregnancy outcomes such as Fetal Growth Restriction. Methods and Materials: A hospital based prospective study was done among 1084 pregnant women attending department of obstetrics and gynaecology, Sree Gokulam Medical College and Research Foundation during the study period from 1st May 2021 to 30th May 2022. All antenatal patients those who have fulfilled the inclusion and exclusion criteria were allocated in the study by random sampling method after obtaining informed consent. Maternal biochemical markers such as Pregnancy Associated Plasma Protein-A andbeta HCG values were obtained from the double marker test done at 11-14 weeks. Data was entered into MS excel 2016 and was analyzed by ANNOVA, mean and standard deviation using SPSS software and data was represented using pie charts and bar charts. Results:Majority of patients belong to age group of 21 to 30years.The mean pre-pregnancy weight of the pregnant women was62.19 ± 8.18kg. The mean body mass index among the pregnant women was 23.77 ± 2.42kg/m2. 54.5% of pregnant women were primigravida. Incidence of FGR was 20.8%.There was statistical significant correlation between B-HCG and PAPP-A with FGR (P value <0.05). Conclusion: It was concluded in present study that there was significant association of maternal serum biochemical markers such as PAPP-A and Beta HCG in FGR.