Background: This is a retrospective study to evaluate the indication of fetal echocardiography and the clinical courses of fetuses diagnosed as congenital heart disease (CHD). Methods: We searched the database of fetal echocardiography performed at Seoul National University Children Hospital from July 2008 to April 2011 and reviewed the medical records of these pregnant women and fetuses. Results: There were 298 pregnant women and 327 fetuses who were examined by fetal echocardiography during this period. The mean gestational age at diagnosis was 26.2짹5.2 weeks. The mean age of the mothers was 32.6짹3.9 years. We could identify indications for fetal echocardiography in 292 cases. The most common indication was abnormal findings in the obstetrical screening sonography (51.7%). Among the 327 fetuses, 314 cases were examined by fetal echocardiography and 13 cases were not. Among the 314 echocardiography results, 127 were normal (40.4%), 14 were minor abnormal findings (4.5%), 35 were simple cardiac anomalies (11.1%), 50 were moderate cardiac anomalies (15.9%), 60 were complex cardiac anomalies (19.1%), 16 were arrhythmias(5.1%) and 12 were twin-to-twin transfusions (3.8%). We analyzed the data of 286 cases after excluding arrhythmias and twin-to-twin transfusions. There were 145 cases diagnosed as CHD. Of the 35 fetuses with simple cardiac anomalies, 15 were lost in follow-up, 20 were born and 1 of these 20 expired after birth. Of the 50 fetuses with moderate cardiac anomalies, 7 were lost in follow-up, 43 were born and 4 of these 43 expired after birth. Of the 60 fetuses with complex cardiac anomalies, 18 were lost in follow-up, 3 were terminated and 39 fetuses were born. 13 of these 39 expired. The most common CHD were TOF and VSD (both 19 cases, 6.6%). Complete AVSD, complete TGA, DORV were also common (9 cases, respectively, 3.1%). There were 149 cases examined by echocardiography after birth. We analyzed the difference between fetal echocardiography and postnatal echocardiography. There was no difference in 78 cases (52.3%), minor differences in 67 (45.0%) and major differences in 4 (2.7%). Conclusion: Fetal echocardiography is a good diagnostic method for CHD and helps to decide postnatal immediate therapeutic plans. It can also help to predict the prognosis of the fetus. Still, there are some discrepancies between pre- and post-natal echocardiographic results, but only a few (2.7%) had major differences resulting in a change in therapeutic plans.