We report the prenatal diagnosis of 2 cases of Pentalogy of Cantrell in the first trimester. In case 1, sonographic evaluation revealed ectopia cor-dis, omphalocele, and cystic hygroma at 10 weeks’ gestation. In case 2, sonographic assessment during the first trimester detected ectopia cordis and ompha-locele at 11 weeks’ gestation. In both cases, the patient opted for elective pregnancy termination, and Pentalogy of Cantrell was confirmed in 2 male fetuses. We discuss the role of Doppler imaging and 3-dimensional sonography as complementary meth-ods to conventional sonographic assessment of ab-dominal wall defects at early pregnancy.