Fetal hydrops is characterized by the accumulation of fluid in at least two different fetal compartments, such as the abdominal cavity, lungs, heart, or skin. This condition can be caused by various factors, either immunological or non-immunological. Immune fetal hydrops results from hemolytic disease of the fetus, caused by maternal antibodies attacking fetal red blood cells. The most common cause of this type of hydrops is RhD alloimmunization, where the mother’s body produces antibodies against RhD-positive fetal red blood cells. Although the use of anti-D immunoglobulin has significantly reduced the frequency of this disorder, there is still a risk of sensitization due to the presence of other Rh antigens or antigens from other blood group systems. In cases of severe anemia caused by hemolytic disease, intrauterine transfusions may be necessary to stabilize the condition. Non-immune fetal hydrops accounts for more than 90% of all cases of fetal hydrops. This form of hydrops can be caused by a range of factors, including cardiac structural and functional abnormalities, chromosomal disorders, malformations, or infections. Diagnosis is made through ultrasound by identifying signs such as ascites, pleural effusion, pericardial effusion, or skin edema. Early detection and monitoring of this condition are crucial for effective treatment and reducing potential complications. A comprehensive approach is essential, including tests to identify the underlying cause and plan appropriate management.