Abstract Delivery of a healthy full term baby following an uneventful antenatal period occurs in the majority of pregnancies. These are classified as a low-risk pregnancy group. There are, however, some pregnancies that are complicated due to maternal or fetal disease that can increase the risk of perinatal morbidity and mortality. This is classified as a high-risk group. The aim of fetal surveillance is to identify these threatened fetuses with the prospect of altering the timing of delivery to prevent the worst outcome, stillbirth. This article looks at the tools available to assess antenatal fetal health in all pregnancies and their ability to identify the at-risk pregnancies that require extra surveillance to improve outcomes. This article does not address fetal surveillance during labour.