Purpose The aim of this study was to investigate the prenatal courses and mana gement of abdominal surgical diseases. Methods Of the 327 patients registered wi th our fetal treatment board since March 2002, 83 fetuses referred to the surgic al department were enrolled for the current study. The prenatal diagnosis, seque ntial fetal images, and perinatal courses of these cases were reviewed retrospec tively. Results Of the 83 cases, abdominal diseases were suspected in 34, lung a nd thoracic diseases in 25, genitourinary diseases in 12, and other anomalies in 12.Meconium peritonitis (MP), intestinal obstruction, and abdominal wall defec ts accounted for approximately 65%of the abdominal diseases. Five patients with prenatally diagnosed lung diseases underwent fetal surgical intervention, and 1 7 of the 22 liveborn patients survived. In contrast, none of the patients with p renatally diagnosed abdominal anomalies underwent fetal surgical intervention, y et, 23 of the 24 liveborn patients survived. However, preterm labor and hydrops were seen frequently in the patients with giant cystic MP, suggesting a fetal cr itical condition. Conclusions Although the clinical outcome of abdominal disease s seemed favorable with postnatal treatment, the current results suggested the o ccurrence of hidden mortality in utero and the potential need for fetal interven tion for some abdominal conditions, such as MP. Purpose The aim of this study was to investigate the prenatal courses and mana gement of abdominal surgical diseases. Methods Of the 327 patients registered wi th our fetal treatment board since March 2002, 83 fetuses referred to the surgic al department were enrolled for the current study Results of the 83 cases, abdominal diseases were suspected in 34, lung a nd thoracic diseases in 25, genitourinary diseases in 12, and other anomalies in 12.Meconium peritonitis (MP), intestinal obstruction, and abdominal wall defec ts accounted for approximately 65% ​​of the abdominal diseases. Five patients with prenatally diagnosed lung diseases underwent fetal surgical intervention, and 1 7 of the 22 liveborn patients survived. In none, none of the patients with p renatally diagnosed abdominal anomalies underwent fetal surgical intervention, y et, 23 of the 24 liveborn patients survived. However, preterm labor and hydrops were seen frequently in the patients with giant cystic MP, suggesting a fetal cr itical condition. The current results suggested the o ccurrence of hidden mortality in utero and the potential need for fetal intervention for some abdominal conditions, such as MP.