Abstract: The umbilical cord is an important connection between the fetus and placenta tissue，is maternal and fetal material exchange link. In recent years，a large number of domestic and international studies have shown that abnormal umbilical cord morphology can cause fetal circulation problems leading to the occurrence of fetal and neonatal severe adverse outcomes，such as fetal growth restriction，fetal distress, neonatal asphyxia or death. The fatality rate of abnormal umbilical cord neonatal was 28.5% reported previously， Therefore，correct understanding of abnormal umbilical cord is very important. In this paper，the relationship between morphological abnormal umbilical cord and fetal outcome is reviewed. And abnormal umbilical cord length，umbilical cord entanglement，umbilical cord twist，umbilical cord knot，abnormal umbilical cord attached，single umbilical artery，and so on, all can affect fetal and neonatal adverse outcomes.

Key words: Umbilical cord, Fetal distress, Fetal growth retardation, Single umbilical artery