Sacrococcygeal teratoma is the most common fetal neoplasm with a reported incidence of 1 in 30,000 to 40,000 births. Affected fetuses carry a high perinatal mortality and morbidity. The aim of this retrospective study was to assess prenatal sonographic aspects and pathological details of our cases with sacroccocygeal teratoma. Over the last seven years we identified six cases by retrospective chart review in our institution. Four fetuses were electively aborted, in two of these four fetuses the diagnosis was made before the 16th week of gestation. Two caesarean sections were performed at 35 + 5 and 37 + 0 weeks of gestation, respectively. In those two cases the diagnosis was only made in the late second and third trimester. No case of neonatal mortality occurred. In one of the two resected sacroccocygeal teratomas potential malignancy was diagnosed. A multidisciplinary approach seems advisible for optimal perinatal management.