Introduction of anti-D prophylaxis both antenatal and postnatal has reduced the incidence of Rh-alloimmunization to 6 per 1000 live births. However, every Rh-negative pregnant woman needs her anti-D antibody evaluation at the first prenatal visit itself. First time sensitized pregnancies need to be monitored by serial ICT titers and when indicated by Doppler ultrasonography of fetal middle cerebral artery for detection of fetal anemia. This chapter covers the follow-up after positive maternal antibody screening test (ICT positive mothers), clinical management of previous fetal or neonatal affection, clinical management of first affected pregnancy, fetal blood transfusion, timing of subsequent transfusion, fetal hydrops, severely anemic early second trimester fetus, timing of delivery, postnatal care, alternative treatment modalities, and prevention of HDFN fetus in future pregnancies.