Hydrocephalus is the term used to describe pathologic dilation of the brain’s ventricular system due to increased CSF pressure. The term antenatal hydrocephalus denotes when ventricular dilatation measures >15 mm or an obstructive etiology is associated with increased CSF pressure during intrauterine period. Advances in fetal diagnostic techniques have opened up many areas to prenatal anatomical scrutiny. Intrauterine hydrocephalus and ventriculomegaly can be diagnosed by prenatal ultrasound between 15 and 35 weeks of gestation. This paper reviewed the current understanding of diagnosis and neurosurgical management of prenatal hydrocephalus.