This chapter provides an in-depth exploration of fetal malformations and syndromic diagnoses, focusing on both diagnostic strategies and condition-specific management. Topics include central nervous system anomalies, craniofacial defects, cardiac malformations, thoracic and abdominal anomalies, and tools for evaluating and managing a malformed fetus. Emphasis is placed on imaging, genetic analysis, interdisciplinary coordination, and prenatal counseling.