Background: Congenital anomalies occur in 2-3% of all births. This is an important cause of perinatal morbidity and mortality and account for 20-30% of perinatal death. The antenatal detection of fetal malformation by early ultrasound screening has been shown to reduce perinatal mortality by allowing elective termination of malformed fetuses. Objective: To compare early targeted organ scanning at gestational ages ranging from 14-16 weeks versus 18-22 weeks. Patients and methods: This prospective observational study was performed at Ultrasound special care unit for the fetus, Ain Shams Maternity Hospital, from January 2016 till December 2019, after obtaining approval from the local ethics committee. One hundred and fifty pregnant women were scanned twice for targeted detailed organ scanning once at 14-16 weeks, then rescanned again at 18-22 weeks. Results: The early-second trimester detailed anatomy scan was significantly less accurate than that of the mid-trimester as regards the heart details. The four chamber view of the heart was well seen at 18-22 weeks in 144 pregnant women (96%) but was only seen at 14-16 weeks in 127 pregnant women (84.7%). The great vessels outflow tracts were better seen at 18-22 weeks in 141 pregnant women (94%), and only seen in 119 pregnant women (79.3%) at 14-16 weeks. Moreover, the kidneys were well visualized at 18-22 weeks in 144 pregnant women (96.0%), and only visualized in 127 pregnant women (84.7%) at 14-16 weeks. There was a significant difference between the two periods regarding all parameters in head, face, the umbilical cord and the external genitalia. Conclusion: None of both gestational ages (14-16 weeks and 18-22 weeks) were clearly superior to the other.