The fetal gastrointestinal tract is amenable to excellent U/S visualization in the second and third trimesters of pregnancy. This enables us to define fetal anatomy and therefore recognize pathology. In this chapter, the fetal U/S gastrointestinal anatomy and pathology have been described. Also the relevant clinical management details have been outlined. The normal fetal esophagus can be demonstrated by US as a set of three to four echogenic parallel lines just anterior to the thoracic aorta. This is best done in the coronal plane. The normal fetal stomach is sonographically visualized as a fluid-filled structure in the left upper abdomen in 30% of embryos at 8 weeks and virtually in all fetuses at 11 weeks onwards. Its anatomical location and shape distinguish it from other abdominal cystic structures. The various fetal gastrointestinal abnormalities which can be recognized prenatally have been described and the clinical management principles have been highlighted.