Background: Ventriculomegaly is most common indicator of many of neural tube anomalies of intrauterine fetus. Presence of which has alarming sign for sonologist to have careful evaluation of fetus for other cranial and extra cranial anomalies. Aim: To evaluate the sonographic difference of fetal ventricle dilatation and neural tube anomalies. Study design: Cross Sectional study. Methodology: Female patients (n=1492) were enrolled in present study held at University Ultrasound Clinic, Green Town, University of Lahore as a reference placement for 6 months. Informed consent was taken from all of them. In this study, pregnant women who underwent ultrasound scanning between 18 and 40 weeks of gestational age were reviewed according to normal size of ventricles and dilatation of ventricles by per abdominal ultrasound having convex transducer with 3.5MHZ frequency. Results: A total of 1492 cases of pregnant women between gestational ages of 18-40 weeks were examined. Normal cases were 1485/1492(99.5%).Total 7-cases were found to have ventricle dilatation. Fetus with mild ventricular dilatation 1/7, with moderate ventricle dilatation were 4/7, 2/4 having moderate ventricle dilatation were associated with neural tube anomalies, severe ventricle dilatation was noted in 2/7, both these fetuses had neural tube anomalies. Conclusion: This study concluded that level of degree of dilatation increases the chances of abnormalities. Early detection provide better counseling opportunity for family to make decisions regarding their fetuses. Keywords: Neural tube defects, Ventriculomegaly, Gestation age and Ultrasonography.