We present our first experience using HDliveFlow with the HDlive silhouette mode for the diagnosis of a persistent right umbilical vein (PRUV) and single umbilical artery (SUA) in a fetus at 28 weeks and 5 days of gestation. Two-dimensional color Doppler showed a single left umbilical artery around the bladder, and PRUV originating from the umbilical cord. HDliveFlow with the HDlive silhouette mode clearly demonstrated SUA and PRUV, and the spatial connection of PRUV to the inferior vena cava through the ductus venosus was detected. The course of the fetal intra-abdominal vasculatures was clarified in detail. Moreover, visualization of the anatomical landmarks, such as the spine was possible using the HDlive silhouette mode. This technique might be a beneficial adjunctive tool for diagnosing fetal peripheral vascular anomalies with advantages over the use of conventional color Doppler alone.