The development of three-dimensional (3D) ultrasound technology has progressively revolutionized the clinical performance of prenatal diagnosis. The 3D technology with its application has allowed generation and navigation into volume data sets, that can be managed online on the ultrasound apparatus as subsequently as offline analysis. The acquisition of a volume in the three orthogonal planes and navigation into the volume was first applied to the study of fetal face and profile. With the advent of the spatiotemporal image correlation (STIC) also the role of the 3D sonography could be enhanced and has demonstrated the importance in being introduced in the study of the fetal heart, initially in normal fetuses and later on in diagnosing congenital heart defects (CHDs). A further step towards the future of fetal cardiology have been the introduction of digital imaging and the electronic matrix probe, providing a higher speed and image resolution than the previous 3D volumetric probes. Artificial intelligence (AI), augmented and virtual reality (AR/VR) and also the 3D printing of fetal structures are novel applications that may potentially represent a further technological breakthrough in fetal echocardiographic examination and might lead to an enhanced prenatal detection of CHDs.