Objective: To investigate the value of prenatal ultrasonography in the diagnosis of fetal hepatic space occupying lesion. Methods: A total of 68 cases of fetal liver space occupying lesion diagnosed by prenatal ultrasonography from July 2011 to December 2015 were enrolled, and the gestational age, position and size of lesion, ultrasonic imaging characteristics, initial prenatal diagnosis, associated malformation and secondary change, as well as the clinical outcome were analyzed. Results: Among the 59 139 cases receiving prenatal ultrasonography, 68 cases were diagnosed as having fetal hepatic space occupying lesion by prenatal ultrasonography, in which 28 cases showing cystic lesion, 24 cases revealing hyperechogenic space occupying lesion, 12 cases showing mixed type space occupying lesion, and 4 cases showing low echogenic space occupying lesion. By imaging or pathologic examination, 23 cases were diagnosed as hepatic cyst, 1 case as biliary atresia, 4 cases as cystic dilatation in bile duct, 18 cases as hepatic calcification, 4 cases as meconium peritonitis, 13 cases as hepatic hemangioma, 1 case as hepatoblastoma, 2 cases as focal nodular hyperplasia, and 2 cases with no confirmed diagnosis. Clinical outcomes included intrauterine death in 2 cases, abortion in 3 cases, neonatal death in 1 case, survival in 61 cases, and lost tracking in 1 case. Conclusions: Prenatal ultrasonography is an important and efficient approach for detection and diagnosis of fetal hepatic space occupying lesion, it might provide a valuable direction for perinatal management of cases with fetal hepatic space occupying lesion.