To report the CNS US findings in a cohort of women that developed clinical symptoms compatible with Zika virus infection during pregnancy in an epidemic area. A total of 129 patients were enrolled in this prospective study performed in Barranquilla, Colombia. Inclusion criteria consisted on the presentation of CDC criteria for symptoms suggestive of Zika virus infection during pregnancy. All patients underwent a monthly US from the moment of the clinical presentation. In each US, fetal biometrics were obtained and a targeted CNS US scan was performed to determine the presence of brain anomalies detectable by US. A total of 257 US scans were analysed. Significant CNS anomalies were identified in 10 cases (4 cases of ventriculomegaly, 1 case of hydrocephalus and microcephaly -HC less than 3SD-, 1 case of isolated parenchymal calcifications, 1 case of anencephaly, 1 case of large choroid plexus cysts and 2 cases of microcephaly with calcifications and agenesis of the corpus callosum). All women were tested for TORCH infections with negative results and normal karyotype, except for one case. Brain anomalies were identified at 22.3 ± 5.5 weeks by 12.1 ± 5.1 weeks after the appearance of Zika virus-compatible symptoms. In 9 cases, viral symptoms occurred in the first trimester (9.3 ± 3.8 weeks) and they appeared to develop CNS anomalies by 11.9 ± 5.3 weeks later. At initial diagnosis of CNS anomalies, HC and BPD were −1.5 ± 2.4 and −2.9 ± 2.5 z scores (Intergrowth21) and −1.1 ± 3.1 and −1.9 ± 2.8 z-scores respectively using Colombian population-based references. Cases in which microcephaly was detected, presented HC at −5.6,-4.3 and −3.2 z scores using Intergrowth21 criteria. Our preliminary results demonstrate how pregnant women can present with clinical symptoms compatible with Zika virus infection in an epidemic area. It is prudent to continue serial scans for potential detection of microcephaly and/or other CNS anomalies until at least 12 weeks after the presentation of clinical symptoms.