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Introduction- Preventive care throughout pregnancy is a major aspect of obstetrics. Proper timely treatment for mothers not only allows for awareness but also allows for the early identification of at-risk populations. The placenta's insufficient blood flow is frequently linked to maternal hypertensive diseases. To detect preeclampsia and FGR and enable early intervention to enhance maternal and perinatal outcomes, this study emphasizes the use of uterine artery Doppler ultrasound in the second trimester. Aims/objectives- To study the effectiveness of uterine artery Doppler indices in the second trimester as a predictor of IUGR and preeclampsia in high-risk pregnancies along with maternal and perinatal outcomes. Material & Methods-. An observational study of 200 women with high-risk factors between 20- 24 weeks was conducted in AVBRH hospital. Following selection criteria, pregnant women were subjected to ultrasound to study abnormal Doppler indices. The outcomes observed were of pre-eclampsia and FGR (fetal growth restriction), mode of delivery, baby weight, and APGAR at birth. Result- Maternal outcomes such as preeclampsia and FGR are more associated with abnormal Doppler indices in high-risk pregnancies. 90 LSCSs and 13 NVDs were observed among the cases with elevated LUA RI (>0.6). The results indicated a substantial correlation between the mode of delivery and the Left Uterine Artery (LUA) Pulsatility Index (PI). RUA RI may function as a predictive marker to identify newborns at risk of low birth weight, 103 Low Birth Weight (LBW) babies. 79 were predicted using raised PI values on Doppler.104 women with abnormal Doppler studies helped in earlier diagnosis of pre-eclampsia. Conclusion- Uterine artery Doppler indices PI, RI, S/D RATIO can be used for the prediction of Preeclampsia. Maternal outcomes such as preeclampsia and perinatal outcomes like low-birth-weight babies, low APGAR score, and IUGR are associated with abnormal uterine artery Doppler indices in high-risk pregnancies