Background The association between perceived decreased fetal movement (DFM) and adverse outcomes in pregnancy is widely acknowl-edged. However, in the general practice setting, a common first point-of-call for pregnant women, guidelines for appropriate management of DFM are lacking. Objective This article reviews the current evidence surrounding women presenting with DFM and suggests appropriate management in the community setting and the indications for hospital referral. Discussion Maternal perception of DFM is a common reason for women to make contact with their healthcare provider. Women presenting on multiple occasions with DFM are at increased risk of poor perinatal outcomes, including fetal death, intrauterine fetal growth restriction (IUFGR) or preterm birth. An evaluation of women presenting with DFM should involve a thorough history, examination and auscultation of fetal heart, cardiotocography (CTG) and ultrasound if indicated.