Ultrasonography is today able to detect many details of the fetal anatomy, so that prenatal diagnosis of malformations becomes possible. However, as 60% of all detected fetal abnormalities develop spontaneously, a screening program is recommended. At least two ultrasonic examinations should be performed. To cope with the huge number of examinations obstetricians in their offices are integrated in this program. Women carrying fetuses with identified or suspected anomalies are sent for further evaluation, management, and counseling to special clinics. The task is to differentiate between lesions which are incompatible with postnatal life, lesions which will necessitate a supporting person for the life of the patient, and lesions which are correctable by surgery. To gain more experience, close cooperation with neonatologists, pediatric surgeons, neurologists, and geneticists is recommended. The first advantages of early prenatal diagnosis have been elective cesarean and reduction of postnatal evaluation and treatment required.