Congenital central nervous system tumors are rare and account for 0.5–1.5% of all childhood brain tumors. Teratoma per ce is the most frequent intracranial tumor. The common location of intracranial teratoma is midline; however, unusual locations in posterior fosa and orbits have been described. Although conventional two dimensional (2D) and three dimensional (3D) ultrasound are the imaging modalities of choice for conducting antenatal evaluation of fetal anomalies, limitations at featuring subtle malformations have been encountered. The aim of this report was to describe imaging, 3DXI performance in the mid trimester fetal evaluation and its postnatal clinical correlation, using Accuvix V10 ultrasonographic equipment (Medison. Seoul-Korea). We obtained fetal volumes in 65 degrees swept. Post-processor software 3DXI viewer (V1.00.0518, Medison, Seoul, Korea) was used. A 32 years old, G1P0 was evaluated with comprehensive ultrasound at 28 weeks old of gestational age. Previous ultrasound 4 weeks ago reported as normal. We saw an intracranial mass in left brain hemisphere with extension to orbit with total extrusion of the eye. The fetal face was totally compromise until fetal nose and compromise of fetal mouth. Polihidramnios was seen, and no other fetal malformations were reported. Patient underwent to EXIT procedure for airway management and a 3100gr baby with APGAR of 8 and 9 was obtained. Postnatal studies included CT, MRI and ultrasound of the baby s head. After a multidisciplinary meeting the baby was considered inoperable and died a week later. Final post mortem examination reported an immature orbit teratoma. There are just a few cases reported in the literature. Although the prenatal diagnosis of fetal intracranial tumors is difficult with conventional ultrasound, the 3D volumes and post process tools should be considered in the fetal evaluation and management plan for therapeutic characterization.