Congenital left ventricular aneurysm is a rare condition characterized by a protrusion or outpouching of a portion of the ventricular wall with broad connection to the ventricular cavity, which may or may not be associated with paradoxical systolic expansion. Only four cases of congenital left ventricular aneurysm diagnosed by prenatal ultrasonography have been reported so far, with the earliest diagnosis at 26 weeks' gestation. 1-3 In all four cases the pregnancy proceeded uneventfully to term, and all neonates were asymptomatic after birth and at follow-up examination between 4 months and 2 years. 1-3 In this report we describe a case of fetal hydrops secondary to a left ventricular aneurysm diagnosed at 19 weeks' gestation. To our knowledge, this is the first case in which a congenital cardiac aneurysm resulted in severe fetal compromise.