Congenital heart defects (CHD) affect nearly between 6 and 12 per 1000 live births in the general population. The 13-week scan was mainly constructed to perform screening for chromosomal anomalies. Recently there was a strong relation between wide NT and negative ductus venosus (DV) with congenital heart later direct heart examination was achievable at acceptable degree of success and at satisfactory levels during the 13-week scan as part of fetal anatomy check at this age of pregnancy. Early diagnosis of major heart anomalies was done with the application of same principles of examining the heart at 2nd trimester. Most of the literature published recently dealing with fetal anatomy at 13-weeks is mentioning the details of heart examination and how to perform it using all methods available including color Doppler and the results were very satisfactory. The higher the crown-rump length (CRL) the better the ability to visualize the fetal heart in details.