Fetal cardiac assessment is essential for monitoring fetal development and early detection of congenital heart disease. This chapter explores the use of three-dimensional (3D) ultrasound as an innovative tool for detailed visualization of fetal cardiac structures. The ability to acquire real-time volumetric images allows for comprehensive analysis of cardiac cavities, septa, and valves, overcoming the limitations of traditional two-dimensional (2D) ultrasound. By detailing the steps to obtain standard views of the fetal heart using 3D ultrasound and highlighting the advantages of advanced techniques such as spatio-temporal image correlation (STIC), this chapter underscores the importance and future potential of 3D technology in fetal cardiology.