The spectrum of abdominal wall defects includes exomphalos (omphalocoele), gastroschisis, and bladder and cloacal exstrophy. These congenital anomalies are readily recognised on a prenatal ultrasound scan. A raised maternal serum alpha-fetoprotein (MSAFP) should also prompt an ultrasound examination looking specifically for these anomalies, as well as neural tube defects. The influence of prenatal diagnosis on the peri- and postnatal management and outcome is still the subject of debate. Most published work relies on patient numbers too small to be of use statistically. Attempting to draw objective conclusions is made difficult because published series come from units with differing facilities and levels of expertise in the many professional groups involved in the management of these often complex anomalies.