Uterine artery Doppler velocimetry has revolutionized the investigation of the developing placental vasculature. Abnormal placental vascular development is the basis of common obstetric disorders such as preeclampsia and intrauterine growth restriction. Uterine artery Doppler velocimetry by itself or in combination with other biochemical markers seems to be an effective first-trimester screening tool for preeclampsia and in particular early-onset preeclampsia. The diagnostic accuracy although statistically significant, is not as high for the prediction of intrauterine growth restriction unrelated to preeclampsia. In the future, first-trimester prophylaxis using antiplatelet agents in Doppler identified high-risk groups could suppress the development of these disorders.