Fetal anasarca, defined by the presence of generalized subcutaneous edema measuring >5 mm tissue thickness, is a rare sonographic finding associated with end-stage hydrops fetalis and impending fetal death.This literature review describes the etiology, diagnosis, treatment, and prognosis for both immune and nonimmune hydrops fetalis. Medical technology and treatment have favorably affected fetal mortality associated with hydrops fetalis. Sonography is a noninvasive procedure that is heavily used in the management of hydrops fetalis. Sonographic guidance is equally important in the diagnosis and treatment. Sonographer recognition of early signs that may precipitate fetal anasarca is vital to continued favorable maternofetal outcome.