<p>Prenatal diagnosis is a cornerstone of modern obstetric care, offering critical insights into fetal health and development. Traditional imaging techniques, while foundational, often suffer from limitations in resolution, depth, and sensitivity, making them insufficient for early and precise anomaly detection. Nanotechnology has emerged as a transformative approach, addressing these challenges using functionalized nanoparticles. These nanoparticles, engineered with tailored surface modifications, target specific fetal tissues or biomarkers with exceptional precision. Nanoparticles enhance resolution, contrast, and specificity by integrating with imaging modalities, such as magnetic resonance imaging, ultrasound, and photoacoustic imaging. For example, iron oxide nanoparticles, quantum dots, and liposome-based systems enable high-definition visualization of complex fetal structures, including the brain, heart, and skeletal system. Surface modification techniques, such as PEGylation and ligand conjugation, improve biocompatibility, reduce toxicity, and ensure targeted delivery, mitigating risks for the mother and fetus. Despite their promise, the widespread adoption of nanoparticle-based imaging raises concerns regarding long-term safety, regulatory challenges, and ethical considerations. This review explores the synthesis, functionalization, and application in fetal anomaly imaging. It also evaluates toxicological findings, emphasizing the need for standardized protocols and rigorous safety assessments. By bridging the gap between technological innovation and clinical practice, nanotechnology-enhanced imaging can redefine prenatal care, ensuring safer pregnancies and better family outcomes worldwide.</p> Graphical Abstract <p></p>