The cumulative experience with fetal biophysical profile scoring as a method for antepartum fetal risk assessment is now extensive. The cumulative data indicate that the method is sensitive for recognizing both the normal and compromised fetus. Moreover, the method appears to offer the advantage of grading various degrees of fetal compromise. The additional information gained by real-time ultrasound scanning (gestational age determination, fetal morphometrics, and fetal anomaly screening), while not an integral part of fetal biophysical profile scoring, nevertheless remains a critical aspect of antepartum fetal assessment. These data are collected simultaneously with the fetal biophysical profile score. It is impossible to separate cleanly the advantages of fetal biophysical profile scoring in isolation of this additional information collected. It would seem that such an attempt at separation is artificial since these data in combination provide more key information to the physician to guide fetal management. It seems reasonable to effect continued modification and improvement of the existing fetal biophysical profile score as a means of antepartum fetal risk assessment.