Heart defects are among the most common malformations in the developing fetus. Carry the highest mortality among all congenital malformations and are very challenging to detect. The fetal heart is notoriously difficult to evaluate due to its complex anatomy and physiology. Many obstetrics ultrasound units are able to successfully obtain and correctly interpret views of the heart, including the four chamber and the outflow tracts views. Unfortunately standards for imaging are not uniform, nationally or internationally with a significant variation in detection rates. While experienced tertiary centers report a high level of diagnostic accuracy, the overall detection rate remains low. Meticulous and preferably standardized screening with referral of the patients with abnormal findings to Pediatric Fetal cardiology specialists would be the ideal approach. This brief manuscript is organized in short paragraphs that are accompanied by illustrations made of drawings as well as real fetal echocardiography pictures that have been conveniently labeled to assist the learner. It should be viewed as a brief introduction to the how-to of the screening fetal cardiac ultrasound examination. Our approach goes beyond the four chamber and outflow views. Our screening fetal ECHO consists of five sequential horizontal slices from fetal abdomen and chest. We believe the best time to perform fetal echocardiogram is around 20 weeks of gestation.