The group of congenital heart diseases (CHD) characterized by involving anomalies of the development of the ventricular outflow tracts of the heart is named “conotruncal malformations.” This group of CHD results from an abnormal development of the conotruncal region of the embryonic heart. Identification of these anomalies in prenatal life remains a challenge since the four-chamber view of the fetal heart is normal in the majority of “conotruncal anomalies.” While the combination of multiple views of the fetal heart such as the ventricular outflow tracts and superior mediastinum has enhanced the prenatal detection of these CHD by two-dimensional ultrasound, there is still considerable scope for further improvement. In light of this, advanced imaging techniques in 3D/4D ultrasound play a crucial role in increasing the detection of these malformations. In this scenario, prenatal diagnosis optimizes obstetric and neonatal care. Furthermore, most of them will undergo cardiac surgery during the first year of life. Therefore, this chapter will discuss the 3D fetal echocardiographic/ultrasound features, extracardiac and chromosomal anomalies associations, prenatal and postnatal outcomes of the following conotruncal anomalies: tetralogy of Fallot (TOF), transposition of the great arteries (TGA), congenitally corrected transposition of the great arteries (cCTGA), truncus arteriosus (TA) and double-outlet right ventricle (DORV).