Fetal echo is generally done when risk of CHD is high in the fetus. However in some centers it has become a routine procedure. Ideal time for fetal echo is between 16-20 weeks of gestational age. In normal fetus, aorta is seen anterior and left to the spine, IVC remains right to the spine. The posterior chamber close to the spine is left atrium and the anterior chamber behind the sternum is the right ventricle. The 4-chamber view of the fetal heart is the most vital window. It allows identification of major congenital anomalies. It is important to image both left and right ventricular outflow tracts, semilunar valves and proximal portions of great arteries. Ductus arteriosus continues with descending aorta (ductal arch). The true aortic arch, which is more superiorly placed, is to be differentiated from the ductal arch. Doppler interrogation helps in identifying shunts, valvular regurgitations and assessing obstructive lesions. Arrhythmia and heart block are easy to identify. M-mode recording gives a better assessment of cardiac rhythm. Complex cardiac anomalies when detected prenatally, in addition to appropriate counselling and advice to parents, necessary steps are to be taken to deal with the anticipated situation. Fetal echocardiography has given rise to the concept of fetal cardiac interventions which may open a new era.