This article begins with an outline of the theoretic basis of the fetal biophysical profile, the method for the biophysical profile score (BPS), and the timing and frequency of testing. The article further discusses the clinical management based on test scores; modified methods of the BPS; and clinical application, predictive accuracy, and impact on outcome of BPS. The authors specifically examine the relationship between BPS and cerebral palsy. They conclude with a discussion of adult sequelae and fetal adaptation to asphyxia.