Background: Congenital cardiac disease is seen in 2–6.5 of 1000 live births and is a major cause of morbidity and mortality, with half of these cases being lethal or requiring surgical correction. Environmental, genetic, and chromosomal abnormalities are believed to be causes of congenital cardiac defects, with a higher incidence among infants with affected siblings or mother. Extra-cardiac abnormalities are associated with 25% of these cases, Aim and objectives: The aim of the present study is to assess the role of ultrasound in diagnosis of fetal cardiac anomalies, Subjects and methods: This was a cross sectional study that was conducted on 100 pregnant ladies between 18 and 40 weeks gestation dated by last menstrual period (LMP) referred to fetal echocardiography unit of radiology department of kasr El Ainy from Banha university hospital and other private clinics with suspected cardiac anomalies by routine obstetric ultrasound, Results: the results that sensitivity of U/S in detection of paediatric heart disease was 100%, specificity was 96.1%, PPV was 96%, NPV was 100%, accuracy was 98% with area under ROC curve 0.99, Conclusion: Prenatal diagnoses of fetal cardiac anomalies made by morphological ultrasonography exhibited good sensitivity, specificity, prenatal to postnatal concordance, and diagnostic validity.