Technology advances have raised the outlook for regenerative solutions aimed at restoring organ health. Fetal surgery, implemented to reinstate early organ growth and restitute function in select congenital conditions, is increasingly considered with the prospect of improved postnatal outcomes. Here, we highlight clinical prenatal interventions for rescue of fetal lung development in congenital diaphragmatic hernia, and fetal neurological regeneration for spina bifida. Regenerative therapeutic care in utero is poised to transform management algorithms.