BackgroundThe study of fetal and placental circulation has focused on the interaction betweens fetal hypoxia and abnormal flow regulation. The assessed methods including spectral and color Doppler US. However, their uses in the depiction of angioarchitecture to make the specific diagnosis are limited.MethodsWe use three‐dimensional (3D) power Doppler sonography (Voluson 530D, Medison; and HDI 3000, ATL) a to detect and visualize the fetal vasculature since 8 weeks gestation. We also use the same method to render the angioarchitecture of placenta as early as 5 weeks gestation. The scanning methods were using either free‐handed or built‐in mechanical probe. We also assess its application in decision making for difficult cases.ResultsPower Doppler provides excellent visualization of fetal circulation (including umbilical vein, portal vein systems, ductus venosus, hepatic veins, etc.). Furthermore, these data can be rendered in 3D perspectives, which is more comprehensive for understanding the complicated vasculature of fetus. It can correlates the embryonic findings in vivo, therefore can confirm the normalcy and also contribute in the diagnosis of pathological state.ConclusionOur results indicate 3D power Doppler is a promising tool in evaluation of complicated fetal and placental anatomy, and might help to make decision in clinical dilemmas.