Background:Pre-eclampsia and intrauterine growth restriction are characterized by abnormal placenta formation, which results in inadequate uteroplacental blood flow. This has led to the idea of using Doppler ultrasonography to assess the velocity of uterine artery blood flow as part of routine ultrasound screening. To find out the sensitivity of uterine artery in the prediction of pregnancy induced hypertension and intrauterine growth restriction at 20-22 weeks of gestation thereby to follow up the at risk patients and to improve perinatal outcome. Methods:Study was conducted at a tertiary care teaching hospital for a period of one year in the department of Obstetrics and Gynecology and in the department of Radiology. Selection of cases about 200 antenatal mothers were selected and they were separated as High risk cases include 100 antenatal mothers (multi) with previous history of hypertension, FGR,IUD at 20-22 weeks of gestation. Low risk cases include 100 antenatal mothers (primi/multi) with no prior history of hypertension, FGR, IUD at 20-22 weeks of gestation.Result:In Group I, out of 97 cases, bilateral notch was noted in 33 cases. There is a significant association between bilateral notch and parity. Two cases had HT, 15 cases had FGR. Insignificant association was noted between bilateral notch and HT. out of 33 cases, FGR was noticed in 15 cases. Significant association was noted between notch and FGR. Out of 33 cases, 6 cases had both HT and FGR. Significant association was noted between notch and HT &FGR. Out of 33 cases, 10 babies were delivered prematurely, 14 cases had caesarean delivery, and 19 cases had vaginal delivery.Conclusion:It is better to do uterine artery Doppler study, along with Target scan at 20-22 weeks of gestation, thereby both anomalies of fetus and risk of preeclampsia, FGR can be predicted in the same visit. Prediction value of uterine artery Doppler study is increased by doing the test along with serum beta HCG, PAPPA, inhibin A. Those cases with bilateral notch require more fetal surveillance and timely intervention compared to unilateral and absent notch.