Congenital heart disease is the most important cause of infant mortality. Abnormalities of the heart and great arteries are the most common congenital defects. Congenital heart disease is often fallow by extracardiac malformations. Many studies revailed positive impact of prenatal diagnosis and timelly treatment on pre-operative condition and outcome of surgery and long term prognosis. Neverthelles, structural cardiac anomalies were also among the most frequently missed abnormalities by prenatal ultrasonography at mid-trimester scan. The 4-chamber view has a Detection Rate of 6-50%, with a reasonable figure of 20% in community setting screening programs. The addition of the outflow determines a significant increase of the Detection Rate which, in most studies, ranges 20-40%. The three-vessel view allows to detect major abnormalities of the arches, the neck vessels and the thymus. The prenatal detection of specific types of congenital heart disease, such as Transposition of great arteries, Hypoplastic left heart syndrome, Tetralogy Fallot, seems to have a significant impact on survival, hospital stay and pre-operative conditions of the affected neonates. Hence, fetal cardiac screening is a must for all health professionals involved in prenatal diagnosis.

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