Fetal echocardiography has clearly made a difference in the world of pediatric cardiology today. It has taught us much about the natural history of fetal cardiac disease, and with ongoing collaborative studies, it should continue to enhance our knowledge base. Fetal echocardiography has enabled us to identify potential candidates for fetal cardiac intervention and has promoted the development of an exciting new discipline within pediatric cardiology. We hope that the recognition of critical congenital heart disease in utero improves the long-term outcome of our patients, including neurodevelopmental outcome and quality of life.