Chronic histiocytic intervillositis (CHI) is a rare form of placental lesion with high fetal morbidity, mortality, and recurrence rate. It most commonly affects the terminal villi, the sites of gas, and the nutrient exchange, closest to the maternal surface. However, it is also frequently observed in other sites and may rarely present with diffuse involvement (1). The CHI is associated with adverse obstetric outcomes including recurrent miscarriage, fetal growth restriction (FGR) and impaired growth in 32% of the pregnancies reaching term, and intrauterine fetal death, with half of the miscarriages occurring at≤ 12 weeks of gestation (2). The definite diagnosis is reliant on postnatal histopathological analysis and the lack of diagnostic biomarkers and consensus on diagnostic criteria that precludes accurate prenatal diagnosis (3). Nevertheless, FGR, oligohydramnious, and abnormal umbilical artery Doppler, especially in the presence of normal uterine arteries Doppler, and abnormal placental morphology in ultrasound can be associated with CHI. Normal uterine artery Doppler indices along with abnormal umbilical artery Doppler presentation strongly suggest that the sole cause of FGR could be linked to placental problems excluding malplacentation. The majority of studies have provided recommendations on how to manage subsequent pregnancies, but the diagnostic value of CHI in current pregnancy and the management of FGR have not been described in the guidelines, thus, neglecting the possibility that the prenatal diagnosis of CHI could facilitate effective treatment options, optimal pregnancy care, and planning for termination of pregnancy, which could improve pregnancy outcomes.