The Amsterdam Consensus Statement introduced the term maternal vascular malperfusion (MVM) to group a constellation of findings associated with impaired maternal-placental circulation. In isolation, these findings are relatively common in placentas from normal gestations, and there is uncertainty on how many, and which, are required. We aim to determine criteria essential for MVM diagnosis in correlations with obstetric outcomes. A total of 200 placentas (100 with a reported diagnosis of MVM, and 100 controls matched by maternal age and GPA-status) were reviewed to document MVM features. Obstetric outcomes in the current pregnancy were recorded including hypertension, pre-eclampsia with or without severe features, gestational diabetes, prematurity, fetal growth restriction, and intrauterine fetal demise. On univariate logistic regression analysis, adverse outcome was associated with low placental weight (<10% percentile for gestational age), accelerated villous maturation, decidual arteriopathy, infarcts (presence and volume), distal villous hypoplasia and excess multinucleated trophoblast in basal plate ≥2mm (all P<0.01), but not with retroplacental hemorrhage. In a multivariable model decidual arteriopathy, infarcts and accelerated villous maturation were significantly associated with adverse outcomes, while low placental weight showed a trend toward significance. A ROC curve including these four parameters showed good predictive ability (AUC 0.8256). Based on the probability of adverse outcome, we recommend consistent reporting of decidual arteriopathy, accelerated villous maturation, infarcts, and low placental weight, summarizing them as “diagnostic of MVM” (decidual arteriopathy or accelerated villous maturation plus any other feature, yielding a probability of 65-97% for adverse obstetric outcomes) or “suggestive of MVM” (if only one feature is present, or the only two features are infarcts plus low placental weight, yielding a probability of up to 52%). Other features such as distal villous hypoplasia, excess (≥2mm) multinucleated trophoblast and retroplacental hemorrhage can also be reported, and their role in MVM diagnosis should be further studied.