Abstract: objective: to explore the clinical significance of prenatal ultrasound in the diagnosis of fetal umbilical artery embolism. Methods: a umbilical artery embolism was found in our hospital from January 2015 to May 2019, and the ultrasonographic images and pregnancy outcomes of 7 fetuses delivered or induced in our hospital were analyzed retrospectively. Results: 7 fetuses showed double umbilical artery at 20-24 weeks. Umbilical artery embolism was found in 7 fetuses after 28 weeks (28-30 weeks). Umbilical artery thrombosis was diagnosed in all cases after delivery, and excessive torsion of umbilical cord was diagnosed in 4 cases after delivery. Among them, 4 cases showed solid echo changes in one umbilical artery. One case was secondary umbilical artery embolism with reduced internal diameter of umbilical artery, and 2 cases were diagnosed as single umbilical artery by ultrasonography after 28 weeks. There were 5 cases of live birth, 3 cases of premature delivery and 2 cases of fetal death in the uterus. There were 4 cases of intrauterine growth restriction and 3 cases of fetal size in accordance with gestational weeks. Conclusion: fetal complications and mortality of umbilical artery embolization are high, which seriously affect fetal prognosis and are closely related to adverse pregnancy outcome. Ultrasound examination in the third trimester of pregnancy should be highly alert to the occurrence of umbilical artery embolism. Once diagnosed, closely monitor the condition of the fetus. Timely termination of pregnancy can effectively reduce perinatal mortality and improve prognosis. Key words: Umbilical artery embolism; Ultrasonic diagnosis; Adverse pregnancy outcome