To determine the perinatal mortality and neonatal morbidity of fetuses with absent end-diastolic velocities (AEDV) of the umbilical artery, the outcome of 120 fetuses, with a gestational age of 24 weeks or more and a birth weight of 500 g or more, with AEDV at the last Doppler examination, were analyzed. The study population came from 348 women who had pregnancies at high risk of placental insufficiency and had had Doppler velocimetry examinations. In all the women, the Doppler velocimetry result was withheld from the clinician managing the woman. Of the fetuses with AEDV, 57 (52%) died and only 26 (22%) babies had minimal or no neonatal morbidity. All 24 fetuses with AEDVs delivering before 28 weeks gestation and having a birth weight less than 750 g died. When compared with fetuses from the study population with end-diastolic velocities present, the gestational age and birth weight at delivery was significantly lower, and the perinatal mortality, neonatal morbidity and number of light for gestational age (LGA) babies was significantly higher in the AEDV group. The LGA babies from both groups were compared by gestational age category and the LGA babies with AEDV still had a significantly higher perinatal mortality. There was no difference in the pattern of neonatal complications or causes of neonatal deaths between the two groups.