The aim of the first trimester fetal anatomy scanning is to confirm the presence of a viable intrauterine pregnancy, to verify the expected delivery date by measuring the CRL, and to identify multiple gestations. Early signs of fetal malformations should be also looked for.The introduction of trans-vaginal ultrasound, color Doppler and three dimensional (3D) ultrasound represent a novel approach for early and accurate detection of fetal malformations. The aim of this study is to describe the role of ultrasound in fetal anatomy scanning in late first trimester and screening for fetal congenital anomalies.