MRI assessment of the fetus using fastT2-weighted sequences is well established in defining alterations in fetal anatomy and structure, as a biomarker for disease, and in some cases prognostication. To date, the physiological assessment of the fetus using advanced sequences to characterise tissue perfusion and microarchitecture has largely been unused. Current methods of assessing fetal organ function are invasive and carry inherent risk. Therefore, the identification of imaging biomarkers of altered fetal physiology, and correlation with postnatal outcome, is attractive. This review describes the techniques which show promise for such a task and potential future directions.