Despite major progress made in obstetrics over recent decades, there is still a lack of knowledge on how to manage the macrosomic fetus. Attention has always been mostly focused on the opposite extreme of the scale of growth, thus resulting in a gap in the literature on the management of large fetuses. Published studies do not even find a consensus on the definition and are designed primarily to detect complications during labor, those that question the outcome of the pregnancy are dated, and there is no meta-analysis.