Neurosonography represents the targeted ultrasound examination of the fetal brain, to be carried out if there is an increased risk or a suspicion of cerebral malformation at screening obstetric ultrasound. Fetal neurosonography is electively carried out transvaginally, and international and national guidelines strongly recommend three-dimensional ultrasound, too. In this chapter, we describe in detail the methodology and the peculiarities of three-dimensional neurosonography. In particular, the steps needed to prepare a volume dataset for clinical assessment are itemized, from acquisition setup to hints for adequate handling of the volume once acquired. In addition, the challenges represented by the acoustic shadowing from calvarial bones are underscored, and suggestions are put forward to solve this problem. Finally, the advantages of three-dimensional ultrasound in fetal neurosonography are illustrated through a few examples of brain abnormalities, such as corpus callosum agenesis, posterior fossa anomalies, and vein of Galen aneurysmal malformation.