Singapore provides a rich environment for investigations into ethnic differences in pregnancy outcome, as it is populated by Malays, Indians, and Chinese. Years of clinical practice and obstetric research in this environment have affirmed the observation that many factors interact in determining length of gestation and birth weight, and that these factors have differential affects among these three different ethnic groups. Although technological advances have furthered our understanding of obstetrical outcomes and provided essential tools to promote the survival of premature infants, the persistent use of uniform growth standards hampers our ability to assure positive outcomes for women of different ethnicity. Recognition of ethnic differences has resulted in declines in certain negative pregnancy outcomes for women in Singapore. The development of race-specific uterine growth curves will enhance the provision of perinatal care for all women.