Introduction/Objective Nowadays Obstetrical and Neonatal practice are facing severe drawbacks caused by the "low birth weight" issue complicating high-risk pregnancies. Multiple factors especially those related to the mother herself like associated comorbidities or the absence of proper antenatal follow-up are susceptible to compel this unfavourable outcome. Active screening through non invasive paraclinical investigations like ultrasound examination of the fetus is set to detect early deviations from normal growth curves and furthermore to initiate efficient diagnosis and treatment plannning. This study aims to present the experience of our Department regarding the efficiency of antepartum ultrasound examination in patients with low birth weight newborns. Materials/Method We developed a prospective case-control study in the Obstetrics and Gynecology Department of "St. Pantelimon" Emergency Hospital in Bucharest referring to all patients admitted for delivery. We considered to be low birth weight all newborns measuring less than 2500g at birth. We sought to analyze the efficiency of fetal biometry in assessing newborns' weight by comparing data from patients who delivered low birth weight babies - case group, with data collected from patients with normal birth weight babies - control group. A statistical analysis was performed on custom ultrasound parameters followed by data appraisal between case and control groups as well as taking into consideration corresponding literature reports. Results Seventy patients have been introduced in our study: 35 women with low birth weight newborns in the case group and 35 women with normal birth weight newborns with no documented comorbidities that could affect fetal intrauterine growth matched the control group. We found that abdominal circumference and biparietal diameter were significantly lower in the case group compared to control data. Particular ultrasound features were noticed for patients known to have medical affections influencing fetal intrauterine growth. Infering the results from our clinic in the european medical background allowed us to report lower biometric values in our study even in the control group. Conclusion/Discussion The first day of last menstrual period was a decissive item for ultrasound examination of fetuses from unsupervised pregnancies. Particular aspects of maternal pathologies causing intrauterine growth restriction were brought into attention by ultrasound evaluation. Third trimester fetal biometry had high accuracy in predicting fetal birth weight; fetal growth curves obtained by biometry measurements showed marked variations between normal birth weight and low birth weight offsprings.