The objective of the study is to determine the importance of the Myocardial Performance Index (MPI) in fetuses with growth restriction and small size for gestational age and how it relates to vascular Doppler results in the identification ofcardiacdysfunction. Method:This is an observational prospective study for evaluation of the value of Myocardial Performance Index in Intrauterine Growth Restricted and Small for Gestational Age fetuses , and its correlation to Umbilical and Middle cerebral artery Doppler findings in detection of cardiac dysfunction.It was carried on 260 singleton pregnancies with gestational age more than or equal to 28 weeks . the population was divided into three groups : SGA (n=60) who had fetal weight centile below 10 and normal Um.A. and MCA RI., IUGR(n=100) who had fetal weight centile below 10 and abnormal Um.A. and MCA RI.,both groups are compared with the third Control (n=100) appropriately grown fetuses with normal doppler. The examination evaluated Isovolumetric contraction time ,Isovolumetric relaxation time and ejection time of the left side of the heart. Myocardial performance index was calculated.