Three-dimensional reconstruction of the normal fetal heart and congenital heart anomalies in the first trimester of pregnancy can still be challenging because of the small size, inappropriate fetal positions, and excessive fetal movement. HDlive Flow can display vascular structures with greater depth perception and dimension. SlowflowHD can depict small peripheral low-velocity blood flow with a high-display frame-rate, high resolution, and favorable sensitivity. In this chapter, we present HDlive Flow and SlowflowHD features of the normal fetal heart and congenital heart anomalies in the first trimester of pregnancy.