Purpose: to compare umbilical artery and middle cerebral Doppler ultrasound values in normal and high risk pregnancies with fetal outcome. Method: 121 consecutive pregnancies (at or over 28 weeks gestation), stratified into low and high risk pregnancies based on clinician information were prospectively examined with doppler ultrasound of UA and MCA. Results: outcome was available for 100 of the 121 patients. 26% of pregnancies had poor outcome. Of these 73% (19) and 27% (7) were classified as high risk and low risk respectively. UA alone or in combination with MCA was shown to have 100% specificity for predicting fetal outcome. However, sensitivities and negative predictive values were poor, ranging from 8-21% and 17-35% respectively. Better positive predictive values were registered in MCA in comparison to those of UA (PPV of 44% and 83% in high risk and low risk categories respectively versus PPV of 0% in both UA high and low risk categories respectively). However, MCA specificities were lower at 80% and 85% for high and low risk pregnancies respectively. Conclusion: the combination of UA and MCA doppler ultrasound examinations is very specific in predicting fetal outcome. However, the sensitivities, positive and negative predictive values were low.