• Maternal perception of reduced fetal movements affects up to 15% of pregnancies.• Reduced fetal movements cause concern and anxiety and can be associated with poor pregnancy outcome.• Up to 29% of women complaining of diminished movements carry a small-for-gestational-age fetus.• Multiple pathologies contibute to reduce fetal movements but in many pregnancies a cause is not found.Learning objectives: • To establish what is meant by ‘reduced fetal movements’.• To understand the assessment tools for women presenting with reduced fetal movements.• To identify the fetus at risk of stillbirth and poor perinatal outcome.• To learn which investigations are useful and which are not, in order to apply appropriate assessment and management strategies.Ethical issues: • Lack of good data on the management of reduced fetal movements.• Failure to recognise pregnancy pathologies in women presenting with reduced fetal movements.• Variation in practice in addressing this condition, with the risk of adverse perinatal outcomes.• Risk of producing iatrogenic problems through over-investigation and unwarranted intervention in a healthy fetus.Please cite this article as: Unterscheider J, Horgan R, O'Donoghue K, Greene R. Reduced fetal movements. The Obstetrician & Gynaecologist 2009;11:245–251.