Backgound: Congenital heart defects (CHD) are the most common congenital malformations. It is six times more common than chromosomal abnormalities and four times more common than neural tube defects. Congenital heart disease accounts for approximately 40% of perinatal deaths due to congenital anomalies and more than 20% of deaths in the first month. Objective: This study aimed to compare the accuracy between fetal and neonatal echocardiography in diagnosing congenital heart disease. Patient and methods: This is a retrograde comparative study that included neonates who underwent echocardiography examination and the results were compared with fetal echocardiographic results available in historical records from prenatal care. 60 pregnant women were referred for fetal echocardiography. The included fetuses in the study were 60 fetuses. It was conducted at the Neonatal Echocardiography Unit, Pediatric Department at Zagazig University Hospitals, from July 2016 to March 2018. Results: Our study showed that out of the 60 cases, fetal echocardiography detected 8 cases out of 24 cases diagnosed with CHD (33.3%), while Neonatal echocardiography detected 24 cases out of 24 cases diagnosed with CHD (100%). Conclusion: The present study demonstrated that fetal cardiovascular diseases, either functional or structural, can be accurately identified by prenatal echocardiography.