The advent of real-time sonography has allowed us to obtain many views of the fetal limbs easily and rapidly. From these images, important parameters regarding the gestational age of the fetus as well as its normality may be derived. The most recently developed equipment allows visualization of fine anatomical detail, providing the base for the diagnosis of a multitude of congenital malformations. As usual, a thorough understanding of fetal sonographic anatomy and its variations is necessary to be able to propose a correct diagnosis.