Advances in prenatal US now enable one to diagnose first trimester gender. Also, gender assignment has significant clinical implications in fetus at risk for x-linked diseases as hemophilia, Duchenne’s muscular dystrophy. Ambiguous genitalia are seen as a component of chromosome anomaly as trisomy 13, triploidy, 13q syndrome. Structurally abnormal genitalia may occur as single malformation, or as components of congenital or inherited syndromes. We demonstrate normal sonographic fetal genital development as gestational age, abnormal male genital malformations as hypospadia, penile chordee, hydrocele, undescended testes, urethral valve, urethral atresia and abnormal female genital malformations as clitomegaly, hydrometrocolpos, rectovestibular fistula with imperforate anus, ovarian cyst with or without torsion. This sonographic acknowledge for fetal genitalia can be helpful in diagnosis and prenatal counseling of gender specific fetal anomalies.