Background Perinatal asphyxia is an important cause of injury to fetal tissues such as the brain, heart, liver and gastrointestinal system. Fetal skin has also been shown to be vulnerable to intrauterine injury after intrauterine ischaemia/reperfusion (I/R) injury. Aim To examine the effect of dexamethasone on fetal skin in intrauterine I/R injury in rats. Methods The response of rat fetal skin to I/R injury and maternal dexamethasone treatment were assessed by determining thiobarbituric acid reactive substances (TBARS), and myeloperoxidase (MPO) and nitric oxide (NO) metabolites. We also examined the ultrastructural changes of fetal skin. Bilateral utero-ovarian artery clamping was performed to produce ischaemia for 30min in rats at day 19 of pregnancy, and reperfusion was achieved by removing the clamps for 60min before fetal tissue was collected. The treatment group was given dexamethasone intraperitoneally 20min before I/R was performed. Results TBARS, MPO and NO all increased significantly in fetal rat skin after I/R injury. Levels of TBARS, MPO and NO were significantly lower in the dexamethasone-treated group than in the I/R-only group. I/R injury produced ultrastructural damage in the epidermis. Oedema and mitochondrial damage were less severe in the dexamethasone-treated group. Conclusions Maternal treatment with dexamethasone may have a protective effect on fetal skin in cases of I/R injury.