Congenital/fetal anomalies are structural, functional, and/or biochemical-molecular defects present at birth whether detected at that time or not. Prevalence of congenital fetal anomalies in developing countries especially in Africa is underestimated. They are seen in 2 to 3% of newborns and about 94% of severe birth defects are seen in low-resource countries. Currently, they account for 20 to 30% of perinatal mortality in developed countries. Their contribution to perinatal mortality may be much higher in developing countries. They are also an important cause of maternal mortality in developing countries because they cause prolonged obstructed labor, ruptured uterus, postpartum hemorrhage, and sepsis. Ultrasound is a very important tool in prenatal diagnosis, but ultrasound usage faces a lot of challenges in Africa. When congenital anomalies are diagnosed in Africa, management becomes a challenge as patients may not even accept the diagnosis or the line of management and this leads to catastrophic complications for the mother and her unborn infant. To overcome these challenges, various measures must be taken, such as training for practitioners, provision of equipments, community enlightenments concerning causes, possible management, and prevention. This review is meant to highlight some of the challenges facing prenatal diagnosis and management of prenatally diagnosed congenital fetal anomalies in low-resource environments and suggest the way forward.