Tetralogy of Fallot is the most common cyanotic congenital heart disease. With the improvement of prenatal screening technology, the rate of prenatal diagnosis has increased significantly, and the demand for prenatal assessment of tetralogy of Fallot has also increased day by day. Echocardiography can evaluate the degree of cardiac malformation in fetuses with tetralogy of Fallot. It has unique advantages and value in prenatal evaluation and is an important means for prenatal evaluation of tetralogy of Fallot. This article reviews the application and progress of echocardiography in fetal assessment of tetralogy of Fallot.