Objectives: To analyse if the gestational age of first diagnosis of fetal conotruncal anomalies (CTA) improves over a period of three decades (from 1993 until 2022) in a tertiary referral centre.Methods: We conducted a retrospective study in a single tertiary referral centre in Germany from 1993-2022 including all cases diagnosed with fetal CTA during pregnancy or in the neonatal period.Fetal CTA included DORV, DOLV, TGA/MGA, TAC, TOF, IAA and APVS.Results: In 170/58.614cases which had at least one fetal echocardiography at our department were diagnosed with CTA.6/170 were diagnosed during neonatal period.There was a significant negative Correlation (p = 0.00001) between gestational age at diagnosis and year of the examination.Peason correlation coefficient was -0.335.51.8% (88/170) were liveborns.Operative interventions were carried out in 78/88 cases (88.6%) which had a curative approach in 68 (87.2%).7/68 children died after curative interventions (9.0%).Mean follow-up was 23.8 months.Conclusions: Our data show that in the last 30 years reliable sonographic detection of one of the most common group of congenital heart defects (CHD) improved significantly in the hand of experts.In recent years it has become feasible to detect this group of CHD much earlier, in many cases during the first trimester-screening (FTS).Reasons may lay in the technical development, better knowledge and training.Our data emphasise the implementation of fetal echocardiography as early as in the first trimester and enhance the status of the FTS.