The human face is a complex anatomical structure with an equally complex embryological development. The knowledge of midface embryogenesis allows an understanding of the pathophysiologic basis of midface anomalies as well as characteristic imaging features and associated anomalies. An understanding of normal developmental anatomy is required to prevent misinterpretation of anatomic variations that may simulate disease and particularly might also help narrowing the differential diagnosis of some midline craniofacial anomalies. An impaired developmental process can lead to various structural abnormalities, ranging from mainly cosmetic deformities to severely invalidating or life-threatening conditions. These lesions can occur as isolated anomalies, or associated with intracranial complex disorders, or can be part of various syndromes, thus serving as diagnostic clues in such cases. Ultrasonography is the first line of prenatal and postnatal investigation. In some challenging situation, fetal MRI can help in diagnostic confirmation, change the diagnosis, and detect abnormalities not detectable by ultrasound. In other cases, a definitive prenatal diagnosis is not reached by either ultrasound or fetal MRI. In other cases, diagnosis is only postnatal by MRI or only after surgery and anatomopathological examination. The fetus or newborn who presents with a middle frontonasal mass often poses a diagnostic challenge to the clinician: Does the mass extend to intracranial level?