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INTRODUCTION: Placental mesenchymal dysplasia, a rare placental vascular anomaly characterized by placentomegaly and grapelike vesicles. Characteristic features of placental enlargement dilated and tortuous chorionic vessels which shows thrombosis. AIMS & OBJECTIVE: THIS IS A CASE REPORT METHODOLGY: 29 YR G4P3L2D1, referred from peripheral civil hospital to the outpatient Department of Obstetrics and Gynaecology, NIMS Hospital, Jaipur at gestation of 33 weeks 6 days with intrauterine growth restriction and severe anemia. Detailed history with general and systemic examination was done. Ultrasonography: A live intrauterine fetus with normal skull, spine, and heart with cephalic presentation. Placenta was fundo-posterior, enlarged, measuring 8.9 cm thickness with multiple irregular cystic areas measuring 57x66 mm. No gross congenital anomalies seen. RESULT & CONCLUSION: Women with PMD are at markedly increased risk of intrauterine fetal death and premature delivery. The diagnosis of PMD should be considered with specific sonographic findings. Patients should be counseled regarding potential complications such as fetal growth restriction, fetal death, premature delivery ,maternal pre-eclampsia Serial growth scans starting in second trimester and continue until delivered should be strongly considered. Early admission to hospital and intensive monitoring of fetal wellbeing status should be considered.