Carlo Luchi Department of Experimental and Clinical Medicine, University of Pisa, Pisa, Italy Abstract: Both new technologies and fetal medicine development have led the perinatologist to a new way of “seeing” the fetus in order to improve maternal and neonatal outcome. Thanks to the inversion of pyramid care, the first trimester anatomical fetal survey has become the moment to identify patients at specific risk of pregnancy complications. This review is based on the latest Literature that prove how ultrasound fetal anatomy can be related not only with chromosomal abnormalities, but also with structural defects, like cardiovascular ones, with developing brain injuries or with developing syndromic diseases; furthermore pregnancy...