Pallister-Killian syndrome (PKS), which is also referred to as tetrasomy 12p, was first described by Pallister [1], and later by . This rare chromosomal anomaly is characterized by tissue-specific mosaicism for a supernumerary isochromosome for the short arm of Pallister-Killian syndrome (PKS) is a rare disorder characterized cytogenetically by tetrasomy 12p for isochromosome of the short arm of chromosome 12. PKS is diagnosed by prenatal genetic analysis through chorionic villous sampling, genetic amniocentesis, and cordocentesis, or by chromosomal analysis of skin fibroblasts, but is not usually detected by chromosomal analysis of peripheral blood cells. Herein, we report a case of a gravida at 23 weeks gestation with pulmonary stenosis and right ventricular dilation of the heart which were detected by sonography. Fluorescence in situ hybridization and a multicolor banding technique were performed to verify the diagnosis as 47,XX, +mar.ish i(12)(p10)(TEL++) [16]/46,XX[4], and an autopsy confirmed the cardiac anomalies detected on antenatal sonography. (Korean J Lab Med 2009;29:366-70)