Intrauterine growth restriction complicates about 5% of pregnancies and is usually caused by chronic placental insufficiency. This article publishes literature review on modern views on chronic placental insufficiency. Special attention is paid to the role of melatonin in chronic placental insufficiency and intrauterine growth. Examples of experimental studies demonstrates the successful course of pregnancy and the development of functional fetal systems in animals with melatonin treatment. The scientific works devoted to the effect of melatonin on the course of pregnancy, in particular, on chronic placental insufficiency in women are described. Also in this review, we suggest that melatonin, a powerful antioxidant, can reduce morbidity and mortality associated with intrauterine growth restriction.