The role of three - dimensional ultrasonography in early diagnosis of congenital malformations during pregnancy , in comparison with the conventional two dimensional ultrasonography as the basic tool, and the four-dimensional ultrasonography as the most advanced tool in real-time radiology, in modern obstetrics. We discussed the three-dimensional ultrasonography mandatory importance and implications in the management of proper antenatal care including intranatal uterine surgical interventions, prevention in subsequent pregnancies, and for the purpose of research studies in a trial of diminishing maternal and fetal morbidity and mortality.