Objective: To determine the perinatal outcome in fetal growth restriction were umbilical artery Doppler end diastolic flow was absent. Methods: A retrospective study performed at the Canary Islands University Hospital. All consecutive cases between 2004 and 2011 were included. We excluded twin pregnancies. Data was abstracted for maternal age, gestational age at diagnosis and delivery, mode of delivery, Apgar and perinatal adverse outcomes. Results: Fifty seven patients were included. Forty three percent had a pregnancy complicated by hypertension and 19[%] diabetes. Mean gestational age at diagnosis was 30+4 weeks. We found 89[%] and 21[%] absent umbilical artery end diastolic flow and reverse flow respectively. Oligohydramnios was seen in 28[%] of the cases. Fetal weight was below the third percentile in 26[%] of the cases. Fetal demise occurred in 3 cases. Mode of delivery was cesarean section in 80[%] of the cases. We found a rate of 17[%] perinatal mortality. At 1 to 6 years follow up 35[%] of the children had no sequelae. Conclusion: Absent end diastolic umbilical flow is associated with a high risk of perinatal mortality. Up to 65[%] of the children will show some type of sequelae. The optimal gestational date for fetal extraction should be individualized after multidisciplinary counseling.