This pictorial review demonstrates details of normal and abnormal skeletal anatomy and offers an approach to the spectrum of fetal skeletal abnormalities that can be identified by use of modern high-resolution ultrasound equipment. These abnormalities, which can occur as isolated findings or be part of a complex syndrome, include anomalies of the head (anencephaly, micrognathia, hypotelorism, decreased mineralization); amniotic band syndrome; anomalies of the spine (myelomeningocele/spina bifida, hemivertebra, sacral agenesis, sirenomelia) and limbs (short radius and ulna, missing hand, missing digit, missing phalanx, lobster claw deformity, polydactyly, overlapping digits and flexed wrists, club foot and rocker bottom foot); and skeletal dysplasias.