Percutaneous fetotomy is the dissection or dismemberment of a fetus with a wire saw by sectioning through the skin, muscle and bone. Subcutaneous fetotomy is performed with chisels and hooks such that the fetal parts are removed while leaving the skin attached to the remainder of the fetus. This paper will review the percutaneous technique using the Utrecht method. To perform a successful fetotomy the obstetrician must have technical knowledge, have adequate training and experience, possess correctly designed instruments, and use copious amounts of lubricant.