Major congenital anomalies are seen in 3% of live births, 15% of cases with perinatal death. Antenatal screening tests are universally recommended for all pregnant women for the early detection of fetal anomalies. After detection of the anomaly, counseling the family regarding its prognosis and outcome becomes necessary. This is currently best done by the team of experts from obstetrics, fetal medicine, pediatric surgery, neonatology, and radiology. Majority of the antenatally detected structural malformations can be closely observed and managed postnatally; with fetal interventions having some role in specific situations.