Abstract:【Objective】To retrospectively analyze the features of prenatal ultrasonography of fetal hypospadias and its clinical significance. 【Methods】From January 2019 to December 2019, the ultrasound data of 41 cases of fetal hypospadias and 1 case of missed diagnosis were analyzed retrospectively. The follow-up results of live births after delivery or induced labor were compared with those of prenatal ultrasound examination and the ultrasound image characteristics of fetal hypospadias were analyzed. 【Results】 Prenatal ultrasound showed 41 cases of fetal hypospadias, 34 of which were confirmed after live birth or induced labor. Among the 34 cases of hypospadias accurately diagnosed by prenatal ultrasound, 19 cases were simple hypospadias and 15 cases were combined with other abnormal hypospadias. One missed case showed only a round and blunt penis head on prenatal ultrasound without clear diagnosis before delivery. However, it was clinically confirmed as coronary groove hypospadias after live birth and delivery; 7 misdiagnosed cases included 2 normal male external genitalia, 2 short penises, 1 case of congenital prepuce, 1 case of webbed penis, and congenital adrenal cortex 1 case of hyperplasia. The prenatal ultrasound diagnosis rate was 80.95% (34/42), the misdiagnosis rate was 16.67% (7/42), and the missed diagnosis rate was 2.38% (1/42). Among the 34 confirmed cases of hypospadias, there were 17 cases of penile type and 17 cases of proximal type. Ultrasound image features of penis type were: fetal penis was short; the degree of curvature was lighter than that of proximal hypospadias; the echo of the penis was slightly enhanced (or no obvious change); the end of the penis was slightly flat; the scrotum was not separated, and there was no "tulip sign". While the ultrasound image characteristics of proximal type showed: the penis was short and small in varying degrees, or the penis was more severely curved to the ventral side; the end of the penis was round and blunt, pointing to the anus; the skin on the dorsal side of the head of the penis was thickened and looks like a turban; the scrotum on both sides was completely or partially separated, and the penis was in the middle showing "tulip sign"; the penis scrotum was completely or partially transposed. 【Conclusion】Prenatal ultrasound examination has important diagnostic value for fetal hypospadias.