&NA;The long‐term goal of examining placentas from patients with adverse pregnancy outcomes has always been to understand better the basic underlying disease processes involved. Through a consideration of clinical, sonographic, laboratory, and anatomic pathological data this goal is now being realized. Placental pathology in the following four clinical scenarios is reviewed: preterm labor, intrauterine growth retardation, intrauterine fetal demise, and birth asphyxia with long‐term adverse sequela.Current Opinion in Obstetrics and Gynecology 1995,7:10‐15