Objectives: Our aim is to describe the technique of fetal intracranial pressure (FIP) assessment developed by using a safe and accurate system of invasive pressure monitoring and registering. Methods: By performing a fetal ultrasound-guided cephalocentesis in the fetal parieto-occipital fissure we may reach the posterior horn of the ventricular cavity. The procedure requires local anesthesia, little or no maternal sedation and no fetal curarization. The technique relies on the use of a sterile disposable pressure transducer that relays pressure information from the intraventricular catheter to a digital monitor in real time. It requires less than 5 seconds for the system to read and plot the pressure values into a graphic describing a straight line with low amplitude oscillations. The pressure transducer has a test port that allows one to verify the accuracy of the system before the fetal punction, minimizing the procedure time. The sensitivity is 5.0 μ V/V/mmHg ±1%, adequate to low pressure ranges. Fetal heart beats should be monitored for bradycardia may occur. Patient should be given uterolythics and has low risk of preterm rupture of membranes after procedure. Discussion: Congenital hydrocephaly has a wide spectrum of presentations and is related to multiple factors. Prognosis depends on the underlying cause, presence of associated malformations, the gestacional age of onset and progression of the ventricle enlargement with brain injury by intracranial hypertension. The FIP assessment may select those who could benefit from intrauterine ventricular derivations, in advanced and progressive cases. The FIP is estimated to be 2mmHg or less in normal fetuses and should be much higher in obstructive hydrocephaly, leading to parenchymal compression and neuronal migration impairment. Conclusions: The technique of FIP measurement is described. Fast, accurate and low-risk assessment may add important information and greatly improve outcome of fetuses with hydrocephaly.