Intrauterine growth restriction (IUGR) results in low birth weight and increased risk of complications such as anemia and impaired thermoregulation. Delayed cord clamping (DCC), performed 30–60 s after birth, enhances hemoglobin and hematocrit levels, reducing neonatal anemia risk, especially in preterm and IUGR infants. A randomized controlled trial (RCT) was conducted at Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar. Thirty-four IUGR neonates with abnormal Doppler findings were randomly allocated to DCC (cord clamped after 1 min) or early cord clamping (ECC) (cord clamped at 30 s). SPSS was used to analyze APGAR scores, hematocrit, hemoglobin, and serum bilirubin levels. The DCC group showed significant improvements in hematocrit, hemoglobin, and APGAR scores (p < 0.05) compared to the ECC group. DCC improves neonatal physiological outcomes without increasing the risk of hyperbilirubinemia, offering evidence-based guidance for cord clamping practices.