Open dysraphisms, including myelomeningocele and myeloschisis, are among the most common central nervous system anomalies prenatally diagnosed. These malformations lead to complex disabilities, including lower-limb sensory-motor disorders, sphincter disorders and cerebral complications. In most cases, open dysraphism are diagnosed prenatally, usually during the second-trimester ultrasound scan. The benefits of fetal surgery for open dysraphism were demonstrated in the early 2010s. Fetal surgery improves motor function and halves the risk of hydrocephalus requiring ventricular shunt. This surgery is performed before 26 weeks of gestation and is indicated for couples whose fetus has an isolated open dysraphism, and who wish to continue the pregnancy. Two techniques of fetal surgery are described: open surgery and fetoscopic surgery. Open surgery was the first to be developed. It requires a hysterotomy, which implies delivery by Caesarean section for the current pregnancy and all subsequent pregnancies. Fetoscopy is a more recent, less invasive technique, which allows vaginal delivery. The main complication of fetal surgery, whatever the technique, is the risk of premature delivery and potential neonatal complications related to prematurity.