The purpose of this literature review was to survey available information and research related to routine three-dimensional (3D) ultrasound technology in obstetrics, with an emphasis on current medical uses, safety, and availability issues. Several data bases, including Cochrane, WHO, NIH, CINALH, Blackwell Synergy, ERIC, PubMed, and Medline, were used along with information from Internet search engines. Although fetal 3D ultrasound is used in both medical and commercial settings, recent studies focus on its possible uses rather than the more difficult issues of safety and commercial applications. Professional organizations associated with ultrasound technology support limiting ultrasounds in pregnancy to medically necessary events, whereas commercial venues use “direct to consumer” marketing to promote this technology as a way to “see” the baby before it is born. How safe is routine or frequent use of 3D ultrasound? Further research is needed to address these important questions.