Fetal echocardiography was performed using a high‐frequency vaginal ultrasound probe in 114 singleton pregnancies between 11 and 16 weeks of gestation. The four‐chamber view with both atria, atrioventricular valves and ventricles as well as the origin and double‐crossing of aorta and pulmonary trunk could always be demonstrated from the 13th week onwards. In 12 of 13 cases, cardiac malformations were diagnosed in the first trimester. Only in one case was transabdominal echocardiography necessary at 20 weeks to make the diagnosis. In several cases, however, additional malformations were overlooked, in particular anomalies of the great arteries, such as coarctation of the aorta. Therefore, the accuracy of second‐trimester transabdominal echocardiography is markedly higher.