Objective To explore the clinical predictive value of ultrasonic peak systolic velocity/end diastolic velocity (S/D) and cerebroplacental ratio (CPR) combined with serum placental growth factor (PLGF) and soluble vascular endothelial factor receptor-1 (sFlt-1) for fetal growth restriction (FGR). Methods A total of 46 late pregnant women with FGR confirmed by ultrasound and 46 late pregnant women with normal fetal development in the hospital were enrolled as FGR group and non-FGR group between May 2021 and May 2023, respectively. The clinical data in the two groups were collected to complete ultrasound examinations. S/D, pulsatility index of middle cerebral artery and umbilical artery were recorded, and CPR was calculated. The fasting venous blood was collected to detect serum PLGF and sFlt-1. The differences in clinical data and the above indexes between the two groups were compared. The influencing factors of FGR were analyzed by multivariate Logistic regression analysis. The clinical predictive value of ultrasound indexes, serum indexes and combined detection for FGR was analyzed by ROC curves. Results The proportion of gestational hypertension in FGR group was higher than that in non-FGR group (P<0.05). S/D in FGR group was greater than that in non-FGR group, while CPR was lower than that in non-FGR group (P<0.05). The level of serum PLGF was lower than that in non-FGR group, while sFlt-1 was higher than that in non-FGR group (P<0.05). The results of multivariate Logistic regression analysis showed that S/D, CPR, PLGF and sFlt-1 were all independent influencing factors of FGR (P<0.05). ROC curves analysis showed that AUC values of S/D, CPR, PLGF and sFlt-1 for predicting FGR were 0.783, 0.835, 0.874 and 0.841, respectively. AUC of combined detection was 0.990, greater than that of single index. Conclusion S/D, CPR, PLGF and sFlt-1 all have good predictive value for FGR, but the combined detection has higher predictive value.