Abstract: This study aims to examine the impact of fetal echocardiography on trends in presentation of neonatal congenital heart diseases (CHD). We retrospectively analyzed data of infants with CHD during newborn screening. Period I, from Jan. 1993 to Dec. 1994, was considered representative of a period before the introduction of fetal echocardiography; while period II, from Jan. 2010 to Dec. 2011, represented a period of more extensive application of fetal echocardiography. Period I group consists of 2,891 newborns by cardiac screening and 2,105 for period II group. The total numbers of infants diagnosed with CHD were 95 among 2,891 (3.3%) in period I group and 66 among 2,105 (3.1 %) in period II group. In period I group, 78 cases were ventricular septal defect (VSD). The others were 8 cases of atrial septal defect (ASD), 2 cases of pulmonary stenosis (PS), 2 cases of patent ductus arteriosus (PDA), one case each of pulmonary atresia, tetralogy of Fallot, hypoplastic left side heart, transposition of great arteries (TGA), and complex CHD, respectively. In Period II group, 56 cases were VSD. Others were ASD (4 cases); PDA (2),PS (2), and one case each of tetralogy of Fallot and endocardial cushing defect, respectively. Of the CHD categories, there was a greater proportion of infants with 'significant' heart diseases in period I group than those in period II group. On the contrary, there was a greater proportion of infants with 'insignificant' heart defects in period II group than those in period I group. In this study, there are no significant changes in incidence of neonatal CHD, but we found that the proportion of infants with 'complex' heart diseases was reduced and 'insignificant' heart defects was increased in period II rather than in period I. Incidence of complex CHD in neonates is decreasing due to widespread early diagnoses by fetal echocardiography and also is related to termination of pregnancies after early prenatal diagnoses of CHD. Our findings showed an alarming high incidence of abortion once the diagnosis of CHD was made. The relatively alarming high abortion rate for various treatable CHD deserves medical and social concerns, especially in the era of child-scare in Taiwan.