The fetal gallbladder can be visualized on most sonographic screening examinations. After obtaining the abdominal circumference images, angling the transducer caudal along the anterior abdominal wall to the level of the umbilical cord insertion will generally bring the gallbladder into view to the right of the umbilical vein. Fetal cholelithiasis and/or sludge in the gallbladder is an uncommon sonographic finding characterized by echogenic material that may or may not produce shadowing. The likelihood of this occurrence is most prevalent in the third trimester of pregnancy. In most cases, fetal gallstones/sludge undergo spontaneous resolution within weeks or months after birth. Most investigators believe that the presence of fetal cholelithiasis or sludge does not alter fetal prognosis or obstetrical management. The finding of an echogenic mass in the abdominal region of the fetal gallbladder should prompt the sonographer to consider sludge and/or gallstones, albeit uncommon, as a possible explanation.