Routine screening for toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus (TORCH) in intrauterine growth restriction (IUGR) and small for gestational age (SGA) neonates has become common practice. However, testing costs may outweigh benefits, especially in countries where the incidence of TORCH is low. To evaluate the efficacy of TORCH screening, medical charts of IUGR or SGA neonates born in a single institution in Bucheon, Korea from 2011 to 2015 were reviewed. Of the 126 IUGR or SGA neonates, 119 (94.4%) had TORCH screening. Patients’ clinical information was gathered, including gestational age, Apgar scores, ultrasonography, chromosome study, morbidities, developmental follow-up, and growth catch-up. Maternal factors including underlying maternal disease and placental findings were also collected. Of the 119 TORCH screenings, only one was positive for toxoplasmosis IgM. This patient had no clinical findings and tested negative for toxoplasmosis IgG. Follow-up until the child was age four years showed no comorbidities. Considering the low incidence TORCH in Korea, the financial costs of the TORCH screening battery, the invasiveness of blood sampling, and low positive TORCH screening in our study, we suggest conservative use of TORCH screening in SGA and IUGR neonates in Korea.