This article reviews developmental skull anatomy, especially as it rel
ates to the formation of cranial sutures and fontanelles, and demonstr
ates the appearance of these structures on prenatal sonograms, illustr
ating the framework these structures provide to enable one to accurate
ly identify components of the fetal skull. Examples are provided to il
lustrate the utility of this knowledge. An understanding of fetal skul
l development and appearance enables the sonographer to better charact
erize fetal cranial abnormalities. More importantly, recognition of th
e location of cranial sutures and fontanelles and their ability to ser
ve as acoustic windows assists the sonographer in evaluation of the fe
tal brain.