BACKGROUND : Fetal growth restriction and oligohydramnios complicate around 7–10% of all pregnancies. Sildenafil citrate a PDE5 inhibitor, being a vasodilator helps in improvement of placental blood flow increasing nutrient and blood supply to the fetus. MATERIALS: A randomized controlled trial was undertaken at a tertiary care institute at Mumbai to evaluate the effect of sildenafil citrate in improving neonatal outcome in cases of FGR and oligohydramnios. Patients in the placebo group and treatment group were followed up with serial USG scan and doppler indices. RESULTS: Patients treated with Sildenafil citrate showed a statistically significant improvement in Doppler indices. This result co–related with increased gestational age at delivery, improved birth weight and better APGAR scores. CONCLUSION: FGR and oligohydramnios, though one of the most common pregnancy issues had a limited treatment approach. The use of sildenafil has revolutionized the management of this condition.