The choice of therapy for fetal growth restriction (FGR) depends on the nature of the insult that led to the development of FGR. Many etiologic factors are either not amenable to therapy or fetal growth has not been improved by treatments that benefit the mother. Many therapeutic approaches have been used to improve fetal condition. None of the approaches have been of value in a consistent manner. We present the numerous approaches, and their rationale for their use, that have been tried to treat the growth impaired fetus. The evidence from the randomized clinical trials is summarized and their conclusions given.