Fetal surgery is the act of opening the gravid uterus, surgically correcting a fetal abnormality, and returning the fetus to the uterus for postoperative recovery and continued gestational development. This article discusses the main advances in fetal surgical therapy aiming to inform health care professionals about the state-of-the-art techniques and future challenges in this field. UCSF Surgeon Reflects on Performing World's First Fetal Surgery30 Years Ago. Fetal therapy is a logical extension of fetal diagnosis. A group of disorders amenable to potential improvement by fetal treatment has been identified, including fetal urinary tract obstruction, fetal diaphragmatic hernia, fetal congenital cystic adenomatoid malformation, fetal sacrococcygeal teratoma, Myelomeningocele, Cardiac ventricular outflow obstruction, and Cerebrospinal fluid obstruction. The discovery of effective to cloys is would be analogous to the development of effective immunosuppression and would allow fetal surgery to achieve its full potential. The fetal surgical experience with each of these lesions is reviewed and the maternal risk of fetal surgery is discussed in the article. The aim of the review is to identify the effectiveness of maternal-fetal surgery for several congenital abnormalities & surgeries of greatest interest including open fetal surgery and fetoscopic surgery and their comparison to post natal surgeries.