Objective: Early detection of very low birth weight infants (VLBWI) in fetal growth restriction (FGR) enables prompt clinical intervention. This study aimed to evaluate the predictive value of placental intravoxel incoherent motion (IVIM) parameters and brain volume, derived from fully automated fetal brain segmentation, for identifying VLBWI in FGR. Methods: This study retrospectively included 23 pregnant women with FGR, categorized into VLBWI group (n = 8) and non-VLBWI group (n = 15) based on birth weight. We compared brain structures as a percentage of intracranial volume and placental IVIM parameters (true diffusion coefficient [D], pseudo-diffusion coefficient [D*], perfusion fraction [f], and placental area) between two groups. Diagnostic efficacy of these parameters were evaluated by using receiver operating characteristic (ROC) curve analyses. Results: Placental D values were significantly lower in VLBWI group compared to non-VLBWI group (1.38±0.04 10-3 mm2 /s vs 1.44±0.07 10-3mm2 /s t=-2.109, P=0.047). Additionally, placental area was smaller in VLBWI group (155.84 ± 34.69 cm2 vs 200.41 ± 47.95 cm2 t=-2.315, P=0.031), while the percentage of lateral ventricle volume relative to intracranial volume was greater in VLBWI group (3.00 ± 0.55 % vs 2.53 ± 0.33 % F=4.528, P=0.046). The areas under the ROC curve for placental D value, placental area, and lateral ventricle as a percentage of intracranial volume were 0.767, 0.783, and 0.792, respectively. After incorporating fetal lateral ventricle as a percentage of intracranial volume, placental D value, and placental, the area under the ROC curve increased to 0.892. Conclusion: Placental IVIM parameters and fetal brain volume may serve as potentially effective imaging markers for distinguishing VLBWI in cases of FGR.