Background, congenital anomaly is a defect that is present at birth, and can result from either genetic, environmental factors, or both. Aim, was to assess the risk factors which may lead to fetal congenital anomalies. Design, a descriptive research design was adopted. Sample, a total of 265 pregnant women were recruited according to the following criteria: pregnant in a fetus with a congenital anomaly; at any reproductive age; no specific gravidity or parity; single or multiple gestations. Setting, Fetal Medicine Unit at El-Manial University Hospital. Tools, two tools were constructed and filled in by the researcher: 1) fetal assessment sheet 2) interviewing questionnair schedule. Conclusion, renal, CNS and muscloskeletal anomalies were the most common type of congenital anomalies. Positive consanguinity, family history for congenital anomalies, previous child with a congenital anomaly, consuming drugs during pregnancy, living near industrial source and exposure to infections during pregnancy, were the most common risk factors associated with congenital anomalies. Recommendations, premarital examination should be encouraged. Antenatal care is very important for early detection.