In 20 consecutive cases of fetal ventriculomegaly, diagnosed by antenatal ultrasound examination, hydrocephalus was isolated in six patients (30%) and was associated with other anomalies in 14 (70%). There were no false positive diagnoses of fetal ventriculomegaly in this series. Fetal structural and/or chromosome abnormalities were diagnosed antenatally in 11 of the 14 patients (78.5%) with postnatally documented anomalies. In ten patients (50%), isolated fetal ventriculomegaly or ventriculomegaly asociated with spina bifida was diagnosed antenatally, and the perinatal management consisted of frequent ultrasound examinations, weekly fetal biophysical profiles, and delivery by cesarean section after documenting fetal lung maturity. Ventriculoamniotic shunt placement was not part of the management. The outcomes were induced abortion, four patients (20%); intrapartum death, two patients (10%); postnatal death, five patients (25%); and currently alive, nine patients (45%).